Individual provider Active NPI

Libbie Sue Stokke, CNP-PMHNP, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Longview, TX
National Provider Identifier
1104804582
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R158703-0 Issued in MN
Practice address
911 W Loop 281 Ste 300
Longview, TX 75604-2934
Phone
(903) 295-8990
Fax
(903) 295-8987
NPI assigned
Jan 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R26277 ND
Family Nurse Practitioner 363LF0000X R158703-0 MN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R158703-0 MN Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP125504 TX

Addresses

Primary practice location

911 W Loop 281 Ste 300
Longview, TX 75604-2934

Mailing address

911 West Loop 281
Suite 300
Longview, TX 75604
Phone (903) 295-8990

Other identifiers 1

IdentifierTypeStateIssuer
19805MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R158703-0MNMDFamily Nurse Practitioner
AP125504TXMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1104804582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 WEST LOOP 281",
            "address_2": "SUITE 300",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "75604",
            "telephone_number": "903-295-8990",
            "fax_number": "903-295-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 W LOOP 281 STE 300",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756042934",
            "telephone_number": "903-295-8990",
            "fax_number": "903-295-8987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOKKE",
        "first_name": "LIBBIE",
        "middle_name": "SUE",
        "credential": "CNP-PMHNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-05",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R26277",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R158703-0",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "R158703-0",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP125504",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19805",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.