Provider Demographics
NPI:1235362781
Name:LISS, ROZA (CRNP)
Entity type:Individual
Prefix:
First Name:ROZA
Middle Name:
Last Name:LISS
Suffix:
Gender:F
Credentials:CRNP
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Other - Last Name:
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Mailing Address - Street 1:941 RUSSELL AVE STE B
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-6206
Mailing Address - Country:US
Mailing Address - Phone:240-848-7692
Mailing Address - Fax:240-608-2456
Practice Address - Street 1:941 RUSSELL AVE STE B
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-6206
Practice Address - Country:US
Practice Address - Phone:240-848-7692
Practice Address - Fax:240-608-2456
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2025-04-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11011667363LP2300X
MDR206181363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care