Provider Demographics
NPI:1831179613
Name:LIERMAN, CONNIE JO (PNP)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:JO
Last Name:LIERMAN
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6301 MOUNTAIN BRANCH CT
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-5838
Mailing Address - Country:US
Mailing Address - Phone:202-232-9022
Mailing Address - Fax:202-232-8494
Practice Address - Street 1:2250 CHAMPLAIN ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2618
Practice Address - Country:US
Practice Address - Phone:202-232-9022
Practice Address - Fax:202-232-8494
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCRN31274363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics