Individual
LARRY D LIEB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA ARNP
Contact information
Practice address
1301 W MAIN ST, LAKE CITY, IA 51449-1585
(712) 464-3171
(712) 464-7412
Mailing address
225 W RANDALL RD, CARROLL, IA 51401-3601
(712) 792-1004
(712) 792-4100
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
D-059739
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5200063
CSA
IA
01
—
D-059739
CRNA LICENSE
IA
Enumeration date
04/27/2006
Last updated
03/07/2023
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