Emily A Lieburn, RD, CD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

3169-29 Issued in WI

Practice address

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522

Phone

(414) 805-7782

NPI assigned

Jan 18, 2021

Last updated

Jan 18, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Emily A Jorgenson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1225627847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6721 N 99TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532245217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-7782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBURN",
        "first_name": "EMILY",
        "middle_name": "A",
        "credential": "RD, CD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-18",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "3169-29",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "JORGENSON",
            "middle_name": "A",
            "credential": "RD, CD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Theresa Liebau
• Elicia A Liebe
• Laura Marie Liebenthal, MA
• William D Lieber, MD
• David E Lieberman, M.D.
• Cynthia Lien, MD
• Elisabeth Lien
• Jared M Lieungh, PAC
• Amanda Liewen, M.D.
• Life Adult Family Home LLC (Life Adult Family Home)

• Registered Dietitian in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Registered Dietitian in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.