KEVIN LIEBMANN (NPI# 1154939064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154939064 |
| Entity Type | Individual |
| Full Name | KEVIN LIEBMANN |
| Practice Address |
208 Bunn Dr Princeton NJ 08540-2851 |
| Mailing Address |
4210 Wessex Pl Princeton NJ 08540-6493 |
| Practice Telephone | 6096834999 |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2020-08-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 26NJ01046900 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | 346148 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4210 Wessex Pl, Princeton, NJ 085406493 | 2015431545 |
| Street Address |
208 BUNN DR |
| City | PRINCETON |
| State | NJ |
| Zip Code | 08540-2851 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407810401 | Beth A Hellstern | Physician Assistant | 208 Bunn Dr, Princeton, NJ 08540-2851 | 2006-04-14 |
| 1558993386 | Jaclyn Vinagre | Nurse Practitioner | 208 Bunn Dr, Princeton, NJ 08540-2851 | 2020-02-10 |
| 1932663713 | Anne Funke | Nurse Practitioner | 208 Bunn Dr, Princeton, NJ 08540-2851 | 2019-01-26 |
| 1467966523 | Kristin Langan | Family Medicine | 208 Bunn Dr, Princeton, NJ 08540-2851 | 2017-11-28 |
| 1609395193 | Beena G. Mahtani | Nurse Practitioner | 208 Bunn Dr, Princeton, NJ 08540-2851 | 2017-09-15 |
| 1508381708 | Mona M Fawzy | Physician Assistant | 208 Bunn Dr, Princeton, NJ 08540-2851 | 2017-08-08 |
| 1750838470 | Gita Roy | Physician Assistant | 208 Bunn Dr, Princeton, NJ 08540-2851 | 2016-09-11 |
| 1922459601 | Kelly Sprague Bell | Physician Assistant | 208 Bunn Dr, Princeton, NJ 08540-2851 | 2016-06-24 |
| 1205849981 | Mark A Wernham | Physician Assistant | 208 Bunn Dr, Princeton, NJ 08540-2851 | 2006-08-14 |
| 1235195157 | Martha E Funkhouser | Dermatology | 208 Bunn Dr, Princeton, NJ 08540-2851 | 2006-04-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003420613 | Samantha Beatriz Manzano | Pharmacist | 301 N Harrison Street, Princeton, NJ 08540 | 2020-09-01 |
| 1306485768 | Allies, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 414 Freedom Blvd, Princeton, NJ 08540 | 2020-01-03 |
| 1124667589 | Allies, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 415 Freedom Blvd, Princeton, NJ 08540 | 2020-01-03 |
| 1215576673 | Allies, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 416 Freedom Blvd, Princeton, NJ 08540 | 2020-01-03 |
| 1508405929 | Allies, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 411 Freedom Blvd, Princeton, NJ 08540 | 2020-01-02 |
| 1992369698 | Suzanne Haggerty | Social Worker | 716 Executive Drive, Princeton, NJ 08540 | 2019-04-28 |
| 1700349552 | Pdp Associates LLC | Social Worker | 3490 Us Highway 1, Building 16 Suite 112, Princeton, NJ 08540 | 2019-04-09 |
| 1245722438 | Kyle Bonner | Social Worker | 166 Bunn Dr Ste 105, Princeton, NJ 08540 | 2018-06-04 |
| 1942700125 | Lifetouch Behavioral Health, LLC | Community/Behavioral Health | 112 Commons Way, Building 1, Suite 112, Princeton, NJ 08540 | 2018-02-14 |
| 1912407271 | Princeton Psychiatry & Consulting, LLC | Psychiatry & Neurology | 601 Ewing St, Suite C-10, Princeton, NJ 08540 | 2018-02-13 |
| Find all providers in zip 08540 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427500461 | Mary Sue Curry | Nurse Practitioner | 617 Mercer St, Princeton, WV 24740-3111 | 2016-10-25 |
| 1720444615 | Jacqui Lynn Hill | Nurse Practitioner | 143 Undercliff Ter, Inas Alattar - Pediatrics, Princeton, WV 24740-2175 | 2016-01-07 |
| 1073950382 | Stefanie Nicosia | Nurse Practitioner | 731 Alexander Rd Ste 202, Princeton, NJ 08540-6345 | 2013-05-28 |
| 1639353741 | Princeton Family Care, Pllc | Nurse Practitioner | 323 C South Jefferson St, Princeton, KY 42445 | 2007-12-26 |
| 1205927084 | James John Martineau | Nurse Practitioner | 1100 7th Ave S, Express Clinic, Princeton, MN 55371-4555 | 2006-09-27 |
| 1578528253 | David Kevin Gray | Nurse Practitioner | 407 12th Street Ext, Princeton, WV 24740-2300 | 2006-04-18 |
| 1447862958 | Deaconess Clinic, Inc | Nurse Practitioner | 1808 Sherman Dr, Princeton, IN 47670-1043 | 2020-08-18 |
| 1982216495 | Deaconess Clinic, Inc | Nurse Practitioner | 1808 Sherman Dr, Princeton, IN 47670-1043 | 2020-08-18 |
| 1790397206 | Deaconess Clinic, Inc | Nurse Practitioner | 312 3rd Ave, Princeton, IN 47670-1014 | 2020-08-18 |
| 1295360501 | Kaitlin Douglas | Nurse Practitioner | 122 12th St, Princeton, WV 24740-2312 | 2020-03-06 |
| Find all providers in PRINCETON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.