Individual
LISA M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7120 S 69TH ST STE 101A, LINCOLN, NE 68516-3868
(402) 520-8955
(833) 471-5257
Mailing address
7120 S 69TH ST STE 101A, LINCOLN, NE 68516-3868
(402) 499-2883
(833) 471-5257
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1216
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23174
BCBS
NE
01
—
P00716684
RAILROAD MEDICARE
NE
Enumeration date
09/23/2005
Last updated
02/01/2024
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