Provider Demographics
NPI:1871773911
Name:MELTZER, LIZA B
Entity type:Individual
Prefix:MRS
First Name:LIZA
Middle Name:B
Last Name:MELTZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 REYNOLDS BEND DR SE
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-2539
Mailing Address - Country:US
Mailing Address - Phone:706-766-9766
Mailing Address - Fax:706-291-7415
Practice Address - Street 1:199 REYNOLDS BEND DR SE
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-2539
Practice Address - Country:US
Practice Address - Phone:706-766-9766
Practice Address - Fax:706-291-7415
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN068992363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner