Individual
KRISTIN ROSE EDA LIBBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
2 PALISADES DR, ALBANY, NY 12205-1438
(518) 458-2000
(518) 458-1524
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
310666
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VX0913321197
HEALTH INSURANCE
MI
Enumeration date
01/15/2022
Last updated
01/18/2022
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