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General NPI Number Information
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NPI Number | 1659057792
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Entity Type | Individual
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Provider Name | LIBERTY MARSHALL POWELL CRNP
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Gender | Female
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Dates
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Enumeration Date | 06/23/2023
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 1366 KINSLEY CT
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City | AUBURN
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State | AL
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Zip | 36830-7584
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Country | US
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Telephone | 334-524-4066
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Fax |
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Provider Business Mailing Address
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Address Line | 907 LAKEVIEW DR
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City | AUBURN
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State | AL
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Zip | 36830-5679
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Country | US
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Telephone | 334-524-4066
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Fax |
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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 | RN9664593
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-087089
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN134762
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License Number State | GA
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