Provider Demographics
NPI:1861705394
Name:STOCKELAND, LIANNA MARIA (RN, CNP)
Entity type:Individual
Prefix:
First Name:LIANNA
Middle Name:MARIA
Last Name:STOCKELAND
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:LIANNA
Other - Middle Name:MARIA
Other - Last Name:WALBURG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7580 BUCKINGHAM BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-3210
Mailing Address - Country:US
Mailing Address - Phone:410-729-5100
Mailing Address - Fax:
Practice Address - Street 1:4201 MITCHELLVILLE RD STE 102
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3175
Practice Address - Country:US
Practice Address - Phone:301-262-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR217312363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily