Provider Demographics
NPI:1447794664
Name:WEST, LIANNE MARIE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:LIANNE
Middle Name:MARIE
Last Name:WEST
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:LIANNE
Other - Middle Name:MARIE
Other - Last Name:VALLEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:51783 461ST AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56003-4207
Mailing Address - Country:US
Mailing Address - Phone:507-381-6012
Mailing Address - Fax:
Practice Address - Street 1:309 HOLLY LN
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-5422
Practice Address - Country:US
Practice Address - Phone:507-388-2120
Practice Address - Fax:507-388-8351
Is Sole Proprietor?:No
Enumeration Date:2016-12-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP 4917363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily