Individual
KIM LEANNE LIBONATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
2801 N GANTENBEIN AVE, NICU, PORTLAND, OR 97227-1623
(503) 413-2304
(503) 413-2145
Mailing address
2801 N GANTENBEIN AVE, NICU, PORTLAND, OR 97227-1623
(503) 413-2304
(503) 413-2145
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
—
OR
Other
Enumeration date
07/16/2007
Last updated
07/16/2007
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