Provider Demographics
NPI:1861694481
Name:DAIZ, LILIAN M (FNP, BC)
Entity type:Individual
Prefix:MS
First Name:LILIAN
Middle Name:M
Last Name:DAIZ
Suffix:
Gender:F
Credentials:FNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7406 NALL AVE., WILLIAMSBROOK CONDOMINIUMS
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66208-2455
Mailing Address - Country:US
Mailing Address - Phone:913-485-5230
Mailing Address - Fax:913-573-6729
Practice Address - Street 1:619 ANN AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66101-3038
Practice Address - Country:US
Practice Address - Phone:913-573-6706
Practice Address - Fax:913-573-6729
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45710363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily