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NPI Code Detail

MEDICARE: SALLY LALIBERTE FNP

MEDICARE: SALLY LALIBERTE FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207N00000XDermatology Physician200944NC
2363L00000XNurse Practitioner200944NC
3363LF0000XFamily Nurse Practitioner200944NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1200944OTHERNCNC #LIC

General Provider Information

NPI Number : 1851372627
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALLY LALIBERTE FNP
Provider Business Mailing Address
First Line : 2000 PERIMETER PARK DR STE 200
Second Line :
City : MORRISVILLE
State : NC
Zip : 27560-8442
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1614 NC HIGHWAY 56
Second Line :
City : CREEDMOOR
State : NC
Zip : 27522-8297
Country : US
Telephone Number : 919-575-6103
Fax Number : 919-575-6817
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2005
Last Update Date : 03/07/2023

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Directions to “ SALLY LALIBERTE FNP” Practice Location

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