Provider Demographics
NPI:1912769878
Name:PFLEGER, LIZA JEAN
Entity Type:Individual
Prefix:
First Name:LIZA
Middle Name:JEAN
Last Name:PFLEGER
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 1:2801 HAWKEN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-1052
Mailing Address - Country:US
Mailing Address - Phone:701-214-0958
Mailing Address - Fax:
Practice Address - Street 1:2801 HAWKEN ST APT 2
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-1052
Practice Address - Country:US
Practice Address - Phone:701-214-0958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND425573747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant