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1033916861 NPI number — LIANNA DIMMOCK FNP

NPI Number: 1033916861
Health Care Provider/Practitioner: LIANNA DIMMOCK FNP

Information about “1033916861” NPI (LIANNA DIMMOCK FNP) exists in 1033916861 in HTML format HTML  |  1033916861 in plain Text format TXT  |  1033916861 in PDF (Portable Document Format) PDF  |  1033916861 in an XML format XML  formats.

NPI Number : 1033916861 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1033916861",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DIMMOCK",
    "FirstName": "LIANNA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "FNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "FINCHER",
    "OtherFirstName": "LIANNA",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "9 CAMPION AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NORWICH",
    "MailingAddressStateName": "CT",
    "MailingAddressPostalCode": "06360-1808",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "860-367-3688",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "761 MAIN AVE BLDG A",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NORWALK",
    "PracticeLocationAddressStateName": "CT",
    "PracticeLocationAddressPostalCode": "06851-1080",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "203-810-4151",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/28/2025",
    "LastUpdateDate": "11/29/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "14510",
        "LicenseNumberStateCode": "CT",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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