Provider Demographics
NPI:1033717988
Name:PEARSON-LIBBY, DENICE KAY
Entity Type:Individual
Prefix:
First Name:DENICE
Middle Name:KAY
Last Name:PEARSON-LIBBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S CHERRY ST STE 102
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:IA
Mailing Address - Zip Code:52641-1964
Mailing Address - Country:US
Mailing Address - Phone:319-385-1519
Mailing Address - Fax:319-986-6927
Practice Address - Street 1:101 S CHERRY ST STE 102
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:IA
Practice Address - Zip Code:52641-1964
Practice Address - Country:US
Practice Address - Phone:319-385-1519
Practice Address - Fax:319-986-6927
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IANAOtherPRIVATE PAY