Individual
LISA C DEGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3563 PRAIRIEVIEW ST STE 300, GRAND ISLAND, NE 68803-4442
(308) 381-0162
(308) 389-4445
Mailing address
PO BOX 9802, GRAND ISLAND, NE 68802-9802
(308) 381-0162
(308) 389-4445
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1453
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24179
BCBS
NE
Enumeration date
07/09/2009
Last updated
11/30/2023
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