Provider Demographics
NPI:1386178085
Name:OLIVER, LIANA (LAC)
Entity type:Individual
Prefix:
First Name:LIANA
Middle Name:
Last Name:OLIVER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:LIANA
Other - Middle Name:L
Other - Last Name:OLIVER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:3621 LOWELL AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-4848
Mailing Address - Country:US
Mailing Address - Phone:727-692-4004
Mailing Address - Fax:
Practice Address - Street 1:1219 LEAVENWORTH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-3214
Practice Address - Country:US
Practice Address - Phone:402-884-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE58171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist