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NPI Code Detail

MEDICARE: REBECCA A LIEBERT APN

MEDICARE: REBECCA A LIEBERT APN
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
1363L00000XNurse Practitioner2751WI
2363L00000XNurse Practitioner829613NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12751OTHERWISTATE LICENSE

General Provider Information

NPI Number : 1588705552
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA A LIEBERT APN
Provider Business Mailing Address
First Line : 501 GOPHER DR
Second Line :
City : TOMAH
State : WI
Zip : 54660-4513
Country : US
Telephone Number : 608-372-2181
Fax Number : 608-374-6648
Provider Business Practice Location Address
First Line : 2300 W SAHARA AVE STE 800
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-4397
Country : US
Telephone Number : 203-666-8145
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2007
Last Update Date : 07/19/2024

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Directions to “ REBECCA A LIEBERT APN” Practice Location

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