Provider Demographics
NPI:1083588727
Name:MANTECON, LILIANA MARGARITA (RN, APRN)
Entity type:Individual
Prefix:
First Name:LILIANA
Middle Name:MARGARITA
Last Name:MANTECON
Suffix:
Gender:F
Credentials:RN, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 PLANK RD STE 210
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70805-3563
Mailing Address - Country:US
Mailing Address - Phone:225-217-4408
Mailing Address - Fax:
Practice Address - Street 1:5151 PLANK RD STE 210
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70805-3563
Practice Address - Country:US
Practice Address - Phone:225-217-4408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-04
Last Update Date:2025-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA224734363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner