Mandy S Liberty, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

26NO11756000 Issued in NJ

Practice address

5809 Main Street
St Vincent de Paul Regional School
Mays Landing, NJ 08330

Phone

(609) 625-1565

NPI assigned

Jan 26, 2018

Last updated

Jan 26, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Mandy S Tantum Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1516924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1205334059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 HICKORY ROAD SUITE 240",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "19462",
            "telephone_number": "800-879-4471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5809 MAIN STREET",
            "address_2": "ST VINCENT DE PAUL REGIONAL SCHOOL",
            "city": "MAYS LANDING",
            "state": "NJ",
            "postal_code": "08330",
            "telephone_number": "609-625-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBERTY",
        "first_name": "MANDY",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-26",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NO11756000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDY",
            "last_name": "TANTUM",
            "middle_name": "S",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Nurse in Mays Landing, NJ
• Providers in Mays Landing, NJ by specialty
• Registered Nurse in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2018; 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.