Individual
JOANNA K LIZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2025 VIRGINIA AVE, CONNERSVILLE, IN 47331-2971
(765) 827-8064
Mailing address
511 W COLLEGE CORNER RD, CENTERVILLE, IN 47330-1167
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
28178390A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71014360A
IN
Other
Enumeration date
07/18/2023
Last updated
10/10/2023
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