Healthcare Provider Details

I. General information

NPI: 1457360596
Provider Name (Legal Business Name): NANCY LYBERGER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 03/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 N MAIN ST
AKRON OH
44310-1456
US

IV. Provider business mailing address

975 N MAIN ST
AKRON OH
44310-1456
US

V. Phone/Fax

Practice location:
  • Phone: 330-762-6246
  • Fax: 330-376-7491
Mailing address:
  • Phone: 330-762-6246
  • Fax: 330-376-7491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP04141
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: