Provider Demographics
NPI:1467784918
Name:LIRIANO, SARA ANGELIC (RN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ANGELIC
Last Name:LIRIANO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 454 BOX 3373
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09250-3300
Mailing Address - Country:US
Mailing Address - Phone:01515-064-2840
Mailing Address - Fax:
Practice Address - Street 1:CMR 411 BLDG 700 ROSE BARRACKS
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09112
Practice Address - Country:US
Practice Address - Phone:049966-283-4719
Practice Address - Fax:049966-283-4721
Is Sole Proprietor?:No
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC220000163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
VADOOOOtherUPIN