LISA C DEGEN (NPI# 1639308893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639308893 |
| Entity Type | Individual |
| Full Name | LISA C DEGEN |
| Credential | PA-C |
| Practice Address |
2116 W Faidley Ave Ste 400 Grand Island NE 68803 |
| Mailing Address |
Po Box 9802 Grand Island NE 68802-9802 |
| Practice Telephone | 3083810162 |
| Practice Fax Number | 3083894445 |
| Mailing Telephone | 3083810162 |
| Mailing Fax Number | 3083894445 |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2018-06-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1453 | NE | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | BCBS | 24179 | 01 |
| Street Address |
2116 W FAIDLEY AVE STE 400 |
| City | GRAND ISLAND |
| State | NE |
| Zip Code | 68803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568955466 | Derek James Kleier | Physician Assistant | 2116 W Faidley Ave Ste 400, Grand Island, NE 68803-4671 | 2018-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467053884 | Christopher Patrin | Counselor | 1811 West 2nd Street, Suite 450, Grand Island, NE 68803 | 2020-11-03 |
| 1942848593 | Specialized Outpatient Services | Counselor | 1811 West 2nd Street Suite 450, Grand Island, NE 68803 | 2019-12-13 |
| 1558910604 | Grand Island Regional Medical Center | General Acute Care Hospital | 3533 Prairieview Street, Grand Island, NE 68803 | 2019-09-10 |
| 1992225817 | Destiny Mostek | Dietitian, Registered | 2201 N. Broadwell Ave, Grand Island, NE 68803 | 2017-06-21 |
| 1184150591 | Brandy Rae Bird | Registered Nurse | Mosaic Msu 2905 West 5th Street, Grand Island, NE 68803 | 2017-05-04 |
| 1831633171 | Karla Jean Sextro | Counselor | 2112 W. Faidley Ave, Grand Island, NE 68803 | 2016-12-06 |
| 1689062895 | Good Hands Clinic PC | Specialist | 524 South Webb Rd, Suite 1, Grand Island, NE 68803 | 2014-12-23 |
| 1346664554 | Lindsey M Modlin | Dental Hygienist | 4234 New York Ave, Grandi Island, NE 68803 | 2014-02-07 |
| 1568711711 | Danessa Marie Kenney | Counselor | 908 N. Howard Ave. Suite 107, Nebraska Children's Home Society, Grand Island, NE 68803 | 2012-09-04 |
| 1649528563 | Nicole Morris | Physical Therapist | 2116 Faidley Ave, Grand Island, NE 68803 | 2012-08-27 |
| Find all providers in zip 68803 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700269487 | Samuel Ali | Physician Assistant | 2697 Baseline Rd Apt 204, Grand Island, NY 14072-1669 | 2015-06-30 |
| 1104842764 | Joseph W Besl | Physician Assistant | 31 Flanigen Ln, Grand Island, NY 14072-2118 | 2006-07-15 |
| 1306142658 | Kurt Kenneth Koch | Physician Assistant | 3016 W Faidley Ave, Grand Island, NE 68803-4109 | 2011-02-03 |
| 1164677126 | Plains Radiology Services PC | Physician Assistant | 3610 Richmond Cir Ste 100, Grand Island, NE 68803-3910 | 2008-11-18 |
| 1750535522 | Darcey Leigh Kramer | Physician Assistant | 729 N Custer Ave, Grand Island, NE 68803-4311 | 2008-11-06 |
| 1336322866 | Jolene Marie Lies | Physician Assistant | 2201 N Broadwell Ave, Grand Island, NE 68803-2153 | 2007-12-06 |
| 1659465631 | Patrick David Powers | Physician Assistant | 2201 N Broadwell Ave, Grand Island, NE 68803-2153 | 2006-10-03 |
| 1033210257 | Richard Charles Treadway Sr. | Physician Assistant | 2201 N Broadwell Ave, Nwivahcs, Grand Island, NE 68803-2153 | 2006-09-26 |
| 1104920461 | Sara G Fill | Physician Assistant | 2116 W Faidley Ave, Grand Island, NE 68803-4645 | 2006-09-08 |
| 1952335465 | Lester Donald Hake | Physician Assistant | 2201 N Broadwell Ave, Grand Island, NE 68803-2153 | 2006-07-10 |
| Find all providers in GRAND ISLAND | ||||
| City | GRAND ISLAND |
| Zip Code | 68803 |
Please comment or provide details below to improve the information on LISA C DEGEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.