Individual
LISA M BECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPA S
Contact information
Practice address
17675 WELCH PLZ, OMAHA, NE 68135-3551
(402) 354-7610
(402) 354-7615
Mailing address
2808 S 80TH AVE, STE 110, OMAHA, NE 68124-3253
(402) 504-3707
(402) 504-3714
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
813
NE
363AM0700X
Medical Physician Assistant
813
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025464000
—
NE
Enumeration date
02/10/2006
Last updated
02/05/2018
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