Provider Demographics
NPI:1588224059
Name:LIEBL, GINA MARIE (APRN-C)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:MARIE
Last Name:LIEBL
Suffix:
Gender:F
Credentials:APRN-C
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Mailing Address - Street 1:9300 E 29TH ST N STE 310
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2160
Mailing Address - Country:US
Mailing Address - Phone:316-612-1833
Mailing Address - Fax:316-612-2420
Practice Address - Street 1:1017 JACKSON ST STE C
Practice Address - Street 2:
Practice Address - City:GREAT BEND
Practice Address - State:KS
Practice Address - Zip Code:67530-4200
Practice Address - Country:US
Practice Address - Phone:620-792-3666
Practice Address - Fax:360-790-3667
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2025-09-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS78773363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily