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General NPI Number Information
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NPI Number | 1710002308
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Entity Type | Individual
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Provider Name | VICKI B. LIENAU FNP
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Gender | Female
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 155 E MARKET ST
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City | RHINEBECK
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State | NY
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Zip | 12572-1720
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Country | US
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Telephone | 845-876-1996
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Fax |
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Provider Business Mailing Address
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Address Line | 19 SOMERS DR
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City | RHINEBECK
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State | NY
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Zip | 12572-1710
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F331474-1
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License Number State | NY
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