Provider Demographics
NPI:1265782429
Name:BAILEY, LIANA MARIAH (FNP)
Entity type:Individual
Prefix:
First Name:LIANA
Middle Name:MARIAH
Last Name:BAILEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LIANA
Other - Middle Name:MARIAH
Other - Last Name:SAUNDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12424 POPPY LN
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96161-2523
Mailing Address - Country:US
Mailing Address - Phone:530-219-7594
Mailing Address - Fax:
Practice Address - Street 1:8665 SALMON AVE
Practice Address - Street 2:
Practice Address - City:KINGS BEACH
Practice Address - State:CA
Practice Address - Zip Code:96143
Practice Address - Country:US
Practice Address - Phone:530-546-1970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVTAPN700802363LF0000X
CA21865363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily