Individual
KRISTEN M LIEBL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LRD
Contact information
Practice address
737 BROADWAY, FARGO, ND 58122-0001
(701) 234-2245
(701) 234-3838
Mailing address
737 BROADWAY, FARGO, ND 58122-0001
(701) 234-2245
(701) 234-3838
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
Primary
674
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51556
—
ND
Enumeration date
02/20/2007
Last updated
12/27/2007
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