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Individual

LISA MARIE BEISTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
18692 BORMAN ST, OMAHA, NE 68135-4171
(402) 682-2722
Mailing address
18692 BORMAN ST, OMAHA, NE 68135-4171
(402) 682-2722

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
6515
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6515
LICENSE NUMBER
NE
Enumeration date
05/22/2021
Last updated
05/22/2021
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