Kelli Ann Licursi, 764981: RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

764981 Issued in NY

Practice address

41 E Post Rd
White Plains, NY 10601-4699

Phone

(914) 482-2388

NPI assigned

Jun 20, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1407531098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4202 HICKORY HOLLOW LN",
            "city": "CARMEL",
            "state": "NY",
            "postal_code": "105122628",
            "telephone_number": "914-482-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 E POST RD",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106014699",
            "telephone_number": "914-482-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICURSI",
        "first_name": "KELLI",
        "middle_name": "ANN",
        "credential": "764981: RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "764981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Andrea Rose Lieberman
• Peter Selig Liebert, M.D., FACS, FAAP
• Regina Lief, MD
• Life by Design Therapeutic & Coaching Services PLLC

• Registered Nurse in White Plains, NY
• Providers in White Plains, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.