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

Mr. Raul P Ibanez Hernandez Sr., APRN

Individual provider Gerontology Nurse Practitioner · NPI 1699571083

Mr. Raul P Ibanez Hernandez Sr., APRN is a Nurse Practitioner in Louisville, Kentucky. Qualified in 2024, 2 years ago. Practices with Park Duvalle Community Health Center, Inc, a 23-clinician group and accepts Medicare assignment. Licensed in Kentucky.

Years since qualifying
2
Licensed in
KY
In the registry since
2025
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.

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Practice location Address checks out

3828 Bardstown Rd
Louisville, KY 40218-1527
Phone: (502) 479-8930
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence AG02250080 (KY)

Record details

NPI number1699571083
Entity typeIndividual (Type 1)
GenderMale
Credentials APRN
Sole proprietorNo
NPI enumeratedFebruary 25, 2025
Last updated in NPPESFebruary 25, 2025
Certification dateFebruary 25, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Park Duvalle Community Health Center, Inc — 23 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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