MEDICARE: MRS. LIANE ELIZABETH MACPHERSON CNM, RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	236121	CA
2	176B00000X	Midwife	557610	TX

General Provider Information

NPI Number	:	1336205491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LIANE ELIZABETH MACPHERSON CNM, RN

Provider Business Mailing Address
First Line	:	250 BON AIR RD
Second Line	:
City	:	GREENBRAE
State	:	CA
Zip	:	94904-1702
Country	:	US
Telephone Number	:	512-468-8237
Fax Number	:	512-994-2660

Provider Business Practice Location Address
First Line	:	12174 N MOPAC EXPY
Second Line	:	STE. A
City	:	AUSTIN
State	:	TX
Zip	:	78758-2910
Country	:	US
Telephone Number	:	512-468-8237
Fax Number	:	512-994-2660

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2006
Last Update Date	:	08/17/2020

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