Individual
ELAINE MARIE LIBERTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
300 TWINING ST BLDG 760, MAXWELL AFB, AL 36112-6027
(334) 953-5200
Mailing address
300 TWINING ST BLDG 760, MAXWELL AFB, AL 36112-6027
(334) 953-5200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1575
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356746994
—
NV
Enumeration date
10/24/2014
Last updated
12/18/2024
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