Organization
LIBERTY MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKIE L MARPLE APRN-F (NURSE PRACTITIONER/OWNER)
(606) 706-4265
Entity
Organization
Contact information
Practice address
108 TAYLOR ST, LIBERTY, KY 42539-3160
(606) 706-4265
(606) 706-4275
Mailing address
108 TAYLOR ST, P.O. BOX 1196, LIBERTY, KY 42539-3160
(606) 706-4265
(606) 706-4275
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3004478
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447281712
NPI
KY
05
—
7815765
—
KY
Enumeration date
04/20/2011
Last updated
10/29/2013
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