Provider Demographics
NPI:1548270945
Name:GENTES, LISA S (APRN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:S
Last Name:GENTES
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:PO BOX 642117
Mailing Address - Street 2:SUITE 103
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-8117
Mailing Address - Country:US
Mailing Address - Phone:402-398-6254
Mailing Address - Fax:402-829-8513
Practice Address - Street 1:5014 L ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68117-1329
Practice Address - Country:US
Practice Address - Phone:402-733-4433
Practice Address - Fax:402-733-1220
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2015-01-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE110397363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE098684413Medicare PIN