Doctor Name: | STACY LIBERATORE |
NPI Number: | 1003118019 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | SP011093 |
Business Practice Address: | 300 Chapel Harbor Dr Suite 102 Pittsburgh, PA - 152384131 |
Business Phone Number: | 4129679220 |
Business Fax Number: | 4129679303 |
Mailing Address: | 300 Chapel Harbor Dr, Suite 102 PITTSBURGH |
State: | PA |
Postal Code: | 152384131 |
Phone Number: | 4129679220 |
Fax Number: | 4129679303 |
NPI Enumeration Date: | 11/23/2010 |
NPI Last Update Date: | 11/23/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | SP011093 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |