MEDICARE: MRS. BRENDALYNN IJEOMA-IBE LIEBERMAN NP

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	363L00000X	Nurse Practitioner	5012382	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4704249739	OTHER	MI	LICENSE NUMBER

General Provider Information

NPI Number	:	1912250242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRENDALYNN IJEOMA-IBE LIEBERMAN NP

Provider Business Mailing Address
First Line	:	10850 PROVIDENCE RD STE 1260
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-2684
Country	:	US
Telephone Number	:	248-766-5786
Fax Number	:

Provider Business Practice Location Address
First Line	:	10850 PROVIDENCE RD STE 1260
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-2684
Country	:	US
Telephone Number	:	248-766-5786
Fax Number	:

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

Provider Enumeration Date	:	10/24/2012
Last Update Date	:	04/29/2025

Similar Medicare Providers

1538256938 — DR. CHRIS FRANKLIN MCCAIN D.M.D
Practice Location Address:

10844 PROVIDENCE RD , SUITE 270
CHARLOTTE, NC
28277-2684

Practice Phone: 704-321-0980
Practice Fax: 704-321-0712

1265878292 — RASHA HUSSEIN MOHAMED PH.D, LCMHC
Practice Location Address:

10850 PROVIDENCE RD # 1111
CHARLOTTE, NC
28277-2684

Practice Phone: 704-360-3637
Practice Fax:

1184201311 — CAMPUS MEDICAL LLC
Practice Location Address:

10850 PROVIDENCE RD # 1005
CHARLOTTE, NC
28277-2684

Practice Phone: 844-888-0404
Practice Fax:

1821942244 — MRS. ENO EKWERE GORDON PT
Practice Location Address:

10850 PROVIDENCE RD
CHARLOTTE, NC
28277-2684

Practice Phone: 704-979-4227
Practice Fax:

1538227418 — DR. ALLEYNE PATRICIA SMITH MD
Practice Location Address:

11230 HYDE POINTE CT
CHARLOTTE, NC
28262-2684

Practice Phone: 704-264-3737
Practice Fax:

1528576147 — MS. CHARLENE DENISE WILLIAMS LPN
Practice Location Address:

11280 HYDE POINTE CT
CHARLOTTE, NC
28262-2684

Practice Phone: 980-339-9452
Practice Fax:

Directions to “ MRS. BRENDALYNN IJEOMA-IBE LIEBERMAN NP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.