MEDICARE: MICHELLE LIBRETTI ARNP

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
1	363LG0600X	Gerontology Nurse Practitioner	ARNP9251816	FL
2	363LA2200X	Adult Health Nurse Practitioner	ARNP9251816	FL

General Provider Information

NPI Number	:	1609316595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE LIBRETTI ARNP

Provider Business Mailing Address
First Line	:	21 HOSPITAL DR STE 270
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-2454
Country	:	US
Telephone Number	:	386-437-5959
Fax Number	:

Provider Business Practice Location Address
First Line	:	21 HOSPITAL DR STE 270
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-2454
Country	:	US
Telephone Number	:	386-437-5959
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2017
Last Update Date	:	09/26/2024

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