Healthcare Provider Details

I. General information

NPI: 1609534809
Provider Name (Legal Business Name): LIBBY HADAN ABERLE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2021
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1719 RUSSELL PKWY STE 700
WARNER ROBINS GA
31088-5765
US

IV. Provider business mailing address

PO BOX 117598
ATLANTA GA
30368-7598
US

V. Phone/Fax

Practice location:
  • Phone: 478-328-7674
  • Fax: 478-328-1393
Mailing address:
  • Phone: 770-442-1911
  • Fax: 770-442-0306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberGAA-NP002111
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: