Provider Demographics
NPI:1326428293
Name:LISCIO, TANYA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:
Last Name:LISCIO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 W JOHN ST STE B
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-8829
Mailing Address - Country:US
Mailing Address - Phone:775-445-5080
Mailing Address - Fax:
Practice Address - Street 1:412 W JOHN ST STE B
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-8829
Practice Address - Country:US
Practice Address - Phone:775-445-5080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN002632363LF0000X
NVRN40348163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse