Provider Demographics
NPI:1134616956
Name:MARCIANTE, LIANELY (ARNP)
Entity type:Individual
Prefix:
First Name:LIANELY
Middle Name:
Last Name:MARCIANTE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6424 GRAND CYPRESS CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-7362
Mailing Address - Country:US
Mailing Address - Phone:954-494-8368
Mailing Address - Fax:
Practice Address - Street 1:6424 GRAND CYPRESS CIR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463
Practice Address - Country:US
Practice Address - Phone:954-494-8368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-17
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9255239363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatalGroup - Single Specialty