Individual
ROBERT A LIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1001 E PRIMROSE ST, SPRINGFIELD, MO 65807
(417) 875-3000
Mailing address
PO BOX 9007, SPRINGFIELD, MO 65808-9007
(417) 875-3462
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2013024800
MO
363L00000X
Nurse Practitioner
Primary
2018030651
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420060129
—
MO
Enumeration date
08/17/2018
Last updated
12/27/2018
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