Individual
LISA L BEHNEKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110-001320
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00067402
RAIL ROAD MEDICARE
—
01
—
P00656321
RAILROAD MEDICARE
—
Enumeration date
08/10/2006
Last updated
09/15/2021
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