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General NPI Number Information
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NPI Number | 1568179513
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Entity Type | Individual
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Provider Name | KATHRYN WALLER LIEBING CNP
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Gender | Female
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Dates
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Enumeration Date | 10/31/2022
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 10506A MONTGOMERY ROAD SUITE 200
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City | MONTGOMERY
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State | OH
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Zip | 45242-4400
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Country | US
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Telephone | 513-246-2343
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Fax | 513-246-4047
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Provider Business Mailing Address
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Address Line | 10506A MONTGOMERY ROAD SUITE 200
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City | MONTGOMERY
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State | OH
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Zip | 45242-4400
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Country | US
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Telephone | 513-246-2343
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Fax | 513-246-4047
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 32767
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN.CNP.0037558
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License Number State | OH
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