Elizabeth Liedtke, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

796986 Issued in CA

Practice address

2620 26TH Ave
Oakland, CA 94601-1907

Phone

(510) 437-2363

Fax

(510) 437-2366

NPI assigned

Sep 20, 2013

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

• Elizabeth Coronel Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1770919847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 26TH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946011907",
            "telephone_number": "510-437-2363",
            "fax_number": "510-437-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 26TH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946011907",
            "telephone_number": "510-437-2363",
            "fax_number": "510-437-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEDTKE",
        "first_name": "ELIZABETH",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-20",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "796986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "CORONEL",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Nurse in Oakland, CA
• Providers in Oakland, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; 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.