Sullivan, Lisa M

Sullivan, Lisa M is an individual health care provider with primary practice located at 7601 Pioneers Blvd , Lincoln NE 68506-4675. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Sullivan, Lisa M can be contacted via phone (402) 484-6677.

Contact Information

Primary practice address
7601 Pioneers Blvd Lincoln NE 68506-4675
Fax: (402) 484-4476
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 20787 Nebraska

Profile Details

NPI number 1740248764
LBN Legal business name Sullivan, Lisa M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2006
Last updated Jan 20th, 2017 - about 7 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 1740248764 NPPES
Nebraska Other 273355 AMI MEDICARE PIN
Nebraska MEDICAID 47078180813 AMI MEDICARE PIN
Nebraska Other NA1330008 AMI MEDICARE PIN

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