Healthcare Provider Details

I. General information

NPI: 1225942840
Provider Name (Legal Business Name): ALI LIBEL FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 EUCLID AVE
KANSAS CITY MO
64124-2323
US

IV. Provider business mailing address

7254 ROE AVE
PRAIRIE VILLAGE KS
66208-2836
US

V. Phone/Fax

Practice location:
  • Phone: 816-474-4920
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number2026045119
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: