Provider Demographics
NPI:1700823564
Name:FOLEY, LIBERTY REBECCA (MSN, CRNP)
Entity Type:Individual
Prefix:MRS
First Name:LIBERTY
Middle Name:REBECCA
Last Name:FOLEY
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 CATHARINE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1835
Mailing Address - Country:US
Mailing Address - Phone:215-925-3223
Mailing Address - Fax:
Practice Address - Street 1:34TH ST & CIVIC CENTER BLVD
Practice Address - Street 2:THE CHILDREN'S HOSPITAL OF PHILADELPHIA
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-590-3174
Practice Address - Fax:267-426-7063
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007223363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics