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General NPI Number Information
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NPI Number | 1609508878
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Entity Type | Individual
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Provider Name | LIENE MUCENIECE MD
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Gender | Female
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Dates
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Enumeration Date | 06/27/2022
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 325 W DIXIE AVE
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-1757
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Country | US
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Telephone | 270-765-5921
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Fax | 270-979-2398
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Provider Business Mailing Address
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Address Line | 5401 4TH ST APT 214
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City | LUBBOCK
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State | TX
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Zip | 79416-4357
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Country | US
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Telephone | 806-905-3744
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 60135
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License Number State | KY
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