Provider Demographics
NPI:1033916861
Name:DIMMOCK, LIANNA (FNP)
Entity type:Individual
Prefix:
First Name:LIANNA
Middle Name:
Last Name:DIMMOCK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LIANNA
Other - Middle Name:
Other - Last Name:FINCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 CAMPION AVE
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-1808
Mailing Address - Country:US
Mailing Address - Phone:860-367-3688
Mailing Address - Fax:
Practice Address - Street 1:9 CAMPION AVE
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-1808
Practice Address - Country:US
Practice Address - Phone:860-367-3688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT14510363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily