Liedke, Michael Albert

Liedke, Michael Albert is an individual health care provider with primary practice located at 1010 E 3Rd St Suite 202, Chattanooga TN 37403-2109. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is his primary health care specialty. Liedke, Michael Albert can be contacted via phone (423) 265-2233.

Contact Information

Primary practice address
1010 E 3Rd St Suite 202 Chattanooga TN 37403-2109
Phone: (423) 265-2233
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN185322 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X RN185322 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 14210 Tennessee

Profile Details

NPI number 1720261365
LBN Legal business name Liedke, Michael Albert
Credentials APRN-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2007
Last updated Jul 30th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720261365 NPPES
Tennessee Other 4310139 BCBS OF TN

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