Provider Demographics
NPI:1912984014
Name:DEHNAM, LIANNE MARGARET (ANP BC)
Entity type:Individual
Prefix:MS
First Name:LIANNE
Middle Name:MARGARET
Last Name:DEHNAM
Suffix:
Gender:F
Credentials:ANP BC
Other - Prefix:
Other - First Name:LIANNE
Other - Middle Name:MARGARET
Other - Last Name:LIPSKIND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1235 WHITEHORSE MERCERVILLE RD
Mailing Address - Street 2:SUITE 316 BLDG. C
Mailing Address - City:MERCERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3810
Mailing Address - Country:US
Mailing Address - Phone:609-581-5586
Mailing Address - Fax:609-581-5779
Practice Address - Street 1:1235 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:SUITE 316 BLDG. C
Practice Address - City:MERCERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08619-3810
Practice Address - Country:US
Practice Address - Phone:609-581-5586
Practice Address - Fax:609-581-5779
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNN088588207R00000X
NJ26NN08858800363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223709512OtherHORIZON
NJ500018409OtherMEDICARE RAILROAD
NJNN088588OtherSTATE LICENSE NUMBER
NJ223709512OtherHORIZON
NJP31805Medicare UPIN