Provider Demographics
NPI:1053735449
Name:LIEBIG, JAIME A (CNM)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:A
Last Name:LIEBIG
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:JAIME
Other - Middle Name:A
Other - Last Name:RECORDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:3001 HOSPITAL DR
Mailing Address - Street 2:DIMENSIONS HEALTHCARE ASSOCIATES MIDWIFERY DEPARTMENT
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1189
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3001 HOSPITAL DR
Practice Address - Street 2:DIMENSIONS HEALTHCARE ASSOCIATES MIDWIFERY DEPARTMENT
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1189
Practice Address - Country:US
Practice Address - Phone:301-618-2244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-06
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR197216367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife