Individual
MEGAN M LUSIENSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
10707 PACIFIC ST STE 101, OMAHA, NE 68114-4762
(402) 397-7989
(402) 397-8703
Mailing address
10707 PACIFIC ST STE 101, OMAHA, NE 68114-4762
(402) 397-7989
(402) 397-8703
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2324
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2324
NE LICENSE
NE
05
—
47077934913
—
NE
Enumeration date
04/10/2019
Last updated
06/05/2020
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