Individual
MR. MICHAEL ALBERT LIEDKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN-BC
Contact information
Practice address
1010 E 3RD ST, SUITE 202, CHATTANOOGA, TN 37403-2109
(423) 265-2233
Mailing address
1010 E 3RD ST STE 202, CHATTANOOGA, TN 37403-2174
(423) 265-2233
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN185322
GA
363LA2100X
Acute Care Nurse Practitioner
Primary
14210
TN
363LA2100X
Acute Care Nurse Practitioner
RN185322
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4310139
BCBS OF TN
TN
Enumeration date
12/05/2007
Last updated
02/02/2026
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