Provider Demographics
NPI:1336635549
Name:CUTTIE, LIANA
Entity type:Individual
Prefix:
First Name:LIANA
Middle Name:
Last Name:CUTTIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 RACETRACK RD NW
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-1795
Mailing Address - Country:US
Mailing Address - Phone:850-863-0883
Mailing Address - Fax:
Practice Address - Street 1:320 RACETRACK RD NW STE 100C
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-1796
Practice Address - Country:US
Practice Address - Phone:850-863-0883
Practice Address - Fax:850-862-0188
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11041830363L00000X
LAAP10029363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily