MEDICARE: DR. LISA M MEINKE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	5792	NE
2	207P00000X	Emergency Medicine Physician	26125	NE

General Provider Information

NPI Number	:	1477716918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA M MEINKE M.D.

Provider Business Mailing Address
First Line	:	988102 NEBRASKA MEDICAL CTR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68198-8102
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	987400 NEBRASKA MEDICAL CTR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68198-4285
Country	:	US
Telephone Number	:	402-559-8333
Fax Number	:	402-559-6637

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2008
Last Update Date	:	04/17/2018

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