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General NPI Number Information
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NPI Number | 1679051676
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Entity Type | Individual
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Provider Name | LIZA VANCE FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/01/2018
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 3027 N CIRCLE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-1179
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Country | US
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Telephone | 719-776-3297
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Fax | 719-776-3297
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Provider Business Mailing Address
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Address Line | 55 DAMONTE RANCH PKWY
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City | RENO
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State | NV
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Zip | 89521-2996
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Country | US
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Telephone | 775-852-9304
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN.0994618
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 811564
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.0994618
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License Number State | CO
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