Breisacher, Lisa G

Breisacher, Lisa G is an individual health care provider with primary practice located at 1919 Lincoln Way 315, Coeur D Alene ID 83814-2527. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Breisacher, Lisa G can be contacted via phone (208) 625-6000.

Contact Information

Primary practice address
1919 Lincoln Way 315 Coeur D Alene ID 83814-2527
Phone: (208) 625-6000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X NP399A Idaho

Profile Details

NPI number 1700883303
LBN Legal business name Breisacher, Lisa G
Credentials L.N.P.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2005
Last updated Jan 27th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700883303 NPPES
Idaho MEDICAID 805545800

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