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NPI Profile for JOHN T LIESSE in SHIPROCK, NM.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Diabetes Educator |
163WD0400X | |||
Registered Nurse |
163W00000X |
| NPI # | 1548405038 |
|
| Status | Active | |
| Credentials | RN (Registered Nurse) | |
| Entity | Individual | |
| Enumeration date | 12/11/2008 | |
| Last updated | 12/11/2008 - About 17 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JOHN T LIESSE
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JOHN T LIESSE, RN