Healthcare Provider Details

I. General information

NPI: 1053503599
Provider Name (Legal Business Name): DR. LISA LYNN SCHLITZKUS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2007
Last Update Date: 05/02/2023
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E BOULDER ST STE 500
COLORADO SPRINGS CO
80909-5533
US

IV. Provider business mailing address

988102 NEBRASKA MEDICAL CTR
OMAHA NE
68198-8102
US

V. Phone/Fax

Practice location:
  • Phone: 719-364-6487
  • Fax:
Mailing address:
  • Phone: 402-559-1010
  • Fax: 402-559-1011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberDR.0063109
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: