Individual
LISA LAVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4732 S 131ST ST, OMAHA, NE 68137-1822
(402) 697-3923
(402) 697-3924
Mailing address
2742 READ ST, OMAHA, NE 68112-3122
(402) 578-9111
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
11/14/2014
Last updated
11/14/2014
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