Individual
MISS LISA MAE MANCHESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
425 N DIERS AVE, GRAND ISLAND, NE 68803-4910
(308) 389-3278
(308) 382-1149
Mailing address
15905 W DODGE RD, APT. 3D, OMAHA, NE 68118-4032
(402) 719-4329
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
66171
NE
363LF0000X
Family Nurse Practitioner
Primary
111261
NE
Other
Enumeration date
09/01/2011
Last updated
12/09/2016
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