Liane Mae Bacon, BSN, RN
Nurse Anesthetist, Certified Registered in Wilkes Barre, PA. Individual provider (NPI-1).
NPI number1699475517
StatusActive
Last updated in NPPESNov 27, 2023
Details
- NPI
- 1699475517
- Entity type
- Individual (NPI-1)
- Name
- Liane Mae Bacon
- Credential
- BSN, RN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 8, 2023
- Certification date
- Nov 27, 2023
- Last updated
- Nov 27, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | RN512192L | PA | Yes |
| 163WG0000X | Registered Nurse, General Practice | RN512192L | PA | |
| 163W00000X | Registered Nurse | RN512192L | PA |
Practice location
1000 E Mountain DrWilkes Barre, PA 18711-0001
Phone 570-808-7300
Mailing address
100 N Academy AveDanville, PA 17822-4903
Phone 570-271-6144
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