Individual
LISA A BLADT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7831 WAKELEY PLAZA, OMAHA, NE 68114
(402) 397-6344
(402) 397-6407
Mailing address
7831 WAKELEY PLAZA, OMAHA, NE 68114
(402) 397-6344
(402) 397-6407
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
18864
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1917021
—
IA
05
—
208707406
—
MO
Enumeration date
07/15/2006
Last updated
07/08/2007
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