Individual
DIANNA CHERYL LIEVANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2602 BUFORD RD, NORTH CHESTERFIELD, VA 23235
(804) 272-8806
(804) 272-2909
Mailing address
2602 BUFORD RD, NORTH CHESTERFIELD, VA 23235-3422
(804) 272-8806
(804) 272-2909
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9106150
FL
Other
Enumeration date
09/13/2011
Last updated
07/08/2019
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