Provider Demographics
NPI:1043801830
Name:NORVELL, LIBBY (OTR/L)
Entity type:Individual
Prefix:
First Name:LIBBY
Middle Name:
Last Name:NORVELL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8205 BURT PLZ APT 6
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4478
Mailing Address - Country:US
Mailing Address - Phone:308-379-8014
Mailing Address - Fax:
Practice Address - Street 1:600 BROOKSTONE MEADOWS PLZ
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-4401
Practice Address - Country:US
Practice Address - Phone:402-289-2696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2500225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist