Individual
LISA MICHELLE WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2201 N BROADWELL AVE, GRAND ISLAND, NE 68803-2196
(308) 382-3660
Mailing address
2003 W KOENIG ST, GRAND ISLAND, NE 68803-5440
(308) 382-3660
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
12258
NE
Other
Enumeration date
10/22/2025
Last updated
10/22/2025
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