KEN IBETO NPI 1053807347

NPI Information

  • NPI: 1053807347
  • Provider Name: KEN IBETO
  • Classification: Clinical Nurse Specialist - 364SH0200X
  • Specialization: Home Health
  • Entity Type: Individual
  • Address: 7646 FOREST GLEN WAY
    LITHIA SPRINGS, GA
    ZIP 30122
  • Phone: (678) 637-6249

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NPI Details

Ken Ibeto is a home health clinical nurse specialist in Lithia Springs, GA. Ken Ibeto NPI is 1053807347. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7646 FOREST GLEN WAY
LITHIA SPRINGS, GA
ZIP 30122-867
Phone: (678) 637-6249
Fax: (404) 393-4950

The enumeration date for this NPI number is 7/10/2018 and was last updated on 7/10/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1364SH0200XClinical Nurse SpecialistHome Health048-R-2014GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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