Individual
LYDIA KAY LIBUTTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
593 EDDY ST BSMT APC, PROVIDENCE, RI 02903-4923
(401) 444-8311
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4541
(401) 444-6779
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN04362
RI
363LF0000X
Family Nurse Practitioner
APRN04362
RI
363LF0000X
Family Nurse Practitioner
RN2336344
MA
Other
Enumeration date
12/11/2024
Last updated
07/15/2025
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