Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Kellen Joseph Ibiza, CNC

Individual provider Health & Wellness Coach · NPI 1043933021

Mr. Kellen Joseph Ibiza, CNC is a Health & Wellness Coach in North Prairie, Wisconsin. Registered with an NPI since 2022.

In the registry since
2022

Practice location Address checks out

108 N Harrison St
North Prairie, WI 53153-9791
Phone: (312) 826-6073
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Health & Wellness Coach (primary) Taxonomy 171400000X

Record details

NPI number1043933021
Entity typeIndividual (Type 1)
GenderMale
Credentials CNC
Sole proprietorNo
NPI enumeratedSeptember 23, 2022
Last updated in NPPESSeptember 23, 2022
Certification dateSeptember 23, 2022