Provider Demographics
NPI:1265675649
Name:LIUBARETS, DASHA L (DNP, APN, CRNA)
Entity Type:Individual
Prefix:MS
First Name:DASHA
Middle Name:L
Last Name:LIUBARETS
Suffix:
Gender:F
Credentials:DNP, APN, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1893 HURON AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113
Mailing Address - Country:US
Mailing Address - Phone:801-232-4618
Mailing Address - Fax:
Practice Address - Street 1:333 NORTH SMITH AVE
Practice Address - Street 2:
Practice Address - City:ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102
Practice Address - Country:US
Practice Address - Phone:651-241-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209011097367500000X
MNR-179658-8163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered