Provider Demographics
NPI:1780696542
Name:CHIZEK-LIERMANN, ANN M (NP)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:CHIZEK-LIERMANN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:M
Other - Last Name:CHIZEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:444 E TIMBER DR
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-2852
Mailing Address - Country:US
Mailing Address - Phone:715-369-2300
Mailing Address - Fax:
Practice Address - Street 1:444 E TIMBER DR
Practice Address - Street 2:
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-2852
Practice Address - Country:US
Practice Address - Phone:715-369-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1753363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43933200Medicaid
WIP00032951OtherRAILROAD
P18966Medicare UPIN
WI018207650Medicare ID - Type Unspecified