Provider Demographics
NPI:1588224059
Name:LIEBL, GINA MARIE (NP)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:MARIE
Last Name:LIEBL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:828 ELMHURST BLVD
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-7406
Mailing Address - Country:US
Mailing Address - Phone:785-827-2500
Mailing Address - Fax:785-827-2515
Practice Address - Street 1:1861 N ROCK RD STE 310
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-1264
Practice Address - Country:US
Practice Address - Phone:316-612-1833
Practice Address - Fax:316-612-2420
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2022-11-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS78773363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily