# ADVANCED PRACTICE DERMATOLOGY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417867789
- **Authorized official:** JENNIFER EBERSOLE ARNP (ARNP)
- **Authorized official phone:** (620) 655-4302

## Contact information

- **Practice address:** 1031 N KANSAS AVE, LIBERAL, KS 67901-2644
- **Practice address phone:** (620) 655-4302
- **Mailing address:** 240 CACTUS LN, TURPIN, OK 73950-2067
- **Mailing address phone:** (620) 655-4302

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/09/2026
- **Last updated:** 09/09/2026