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Individual

MS. LISA J STILLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
425 N 30TH ST, OMAHA, NE 68131-2100
(402) 452-5000
(402) 452-5028
Mailing address
555 N 30TH ST, OMAHA, NE 68131-2136
(402) 280-8100
(402) 280-8103

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
236
NE
237700000X
Hearing Instrument Specialist
236
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0588186
IA
01
06609
BCBS BT
NE
01
06617
BCBS ENT
NE
05
100251703-00
NE
05
100251704-00
NE
05
1588186
IA
05
2588186
IA
05
3588186
IA
Enumeration date
01/15/2007
Last updated
11/22/2010
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