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Individual
EMMA LAUREN LIETZ
Active
Individual
EMMA LAUREN LIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110008741
VA
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30017491380002
—
VA
Enumeration date
05/26/2022
Last updated
05/06/2026
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