Provider Demographics
NPI:1952382244
Name:LIEFER, MAUREEN K (RN)
Entity type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:K
Last Name:LIEFER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:K
Other - Last Name:CASETTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:6172 RICHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:RED BUD
Mailing Address - State:IL
Mailing Address - Zip Code:62278-4632
Mailing Address - Country:US
Mailing Address - Phone:618-282-2072
Mailing Address - Fax:
Practice Address - Street 1:6172 RICHFIELD RD
Practice Address - Street 2:
Practice Address - City:RED BUD
Practice Address - State:IL
Practice Address - Zip Code:62278-4632
Practice Address - Country:US
Practice Address - Phone:618-282-2072
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO070157163W00000X
IL163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse