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NPI Code Detail

MEDICARE: LORI KAY LIBERATOR FNP

MEDICARE: LORI KAY LIBERATOR FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP2998AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487824660
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI KAY LIBERATOR FNP
Provider Business Mailing Address
First Line : 2840 N DYSART RD
Second Line :
City : GOODYEAR
State : AZ
Zip : 85395-2338
Country : US
Telephone Number : 866-389-2727
Fax Number : 401-652-9787
Provider Business Practice Location Address
First Line : 2840 N DYSART RD
Second Line :
City : GOODYEAR
State : AZ
Zip : 85395-2338
Country : US
Telephone Number : 866-389-2727
Fax Number : 401-652-9787
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2008
Last Update Date : 02/06/2019

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Directions to “ LORI KAY LIBERATOR FNP” Practice Location

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