Healthcare Provider Details

I. General information

NPI: 1932030210
Provider Name (Legal Business Name): KEYLEE MARIA ALBA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 W 15TH ST
LIBERAL KS
67901-2455
US

IV. Provider business mailing address

315 W 15TH ST
LIBERAL KS
67901-2455
US

V. Phone/Fax

Practice location:
  • Phone: 620-309-0066
  • Fax:
Mailing address:
  • Phone: 620-624-1651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number13-166408-011
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: