| Doctor Name: | MRS. JACQUELINE D LIESS |
| NPI Number: | 1093961898 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN (NNP-BC) |
| License Number: | 110954 |
| Business Practice Address: | 10 E 31st St Kearney, NE - 688472926 |
| Business Phone Number: | 3088657139 |
| Business Fax Number: | |
| Mailing Address: | 4722 Avenue E, KEARNEY |
| State: | NE |
| Postal Code: | 688478305 |
| Phone Number: | 3088657139 |
| Fax Number: | |
| NPI Enumeration Date: | 08/12/2008 |
| NPI Last Update Date: | 08/12/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LN0005X |
| License Number: | 110954 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Neonatal, Critical Care |
| Taxonomy Definition: | |