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General NPI Number Information
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NPI Number | 1528612405
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Entity Type | Individual
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Provider Name | LIUBA PRAGLE NP
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Gender | Female
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Dates
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Enumeration Date | 07/29/2019
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Last Update Date | 12/11/2020
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Provider Practice Location Address
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Address Line | 921 SETON DR STE FANDG
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City | CUMBERLAND
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State | MD
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Zip | 21502-1852
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Country | US
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Telephone | 240-522-0098
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Fax | 240-522-0099
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Provider Business Mailing Address
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Address Line | PO BOX 1602
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City | CUMBERLAND
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State | MD
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Zip | 21501-1602
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Country | US
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Telephone | 240-362-7025
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Fax | 240-362-7571
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F11180797
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License Number State | MD
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