Colette S Libertin, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

COA.15253-NP Issued in OH

Practice address

1622 E Turkeyfoot Lake Rd Ste 100
Akron, OH 44312-5277

Phone

(330) 543-3686

Fax

(330) 543-4008

NPI assigned

Oct 10, 2006

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1346337342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-543-3686",
            "fax_number": "330-543-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 E TURKEYFOOT LAKE RD STE 100",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443125277",
            "telephone_number": "330-543-3686",
            "fax_number": "330-543-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBERTIN",
        "first_name": "COLETTE",
        "middle_name": "S",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.15253-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clibertin341@direct.chmca.org",
            "affiliation": "N",
            "address_1": "1622 E Turkeyfoot Lake Rd Ste 100",
            "city": "Akron",
            "state": "OH",
            "country_code": "US",
            "postal_code": "443125277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Nurse Practitioner in Akron, OH
• Providers in Akron, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.