Provider Demographics
NPI:1194430397
Name:WILSON-PAWLICK, LIANA (CNP)
Entity type:Individual
Prefix:
First Name:LIANA
Middle Name:
Last Name:WILSON-PAWLICK
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4983 COMMON MARKET PL
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-9703
Mailing Address - Country:US
Mailing Address - Phone:740-485-0841
Mailing Address - Fax:
Practice Address - Street 1:4983 COMMON MARKET PL
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-9703
Practice Address - Country:US
Practice Address - Phone:740-485-0841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031772363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily