Healthcare Provider Details

I. General information

NPI: 1568325538
Provider Name (Legal Business Name): LISA PALERMO BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2025
Last Update Date: 12/06/2025
Certification Date: 12/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2231 LINCOLN RD
BELLEVUE NE
68005-3907
US

IV. Provider business mailing address

6228 S 140TH AVE
OMAHA NE
68137-2870
US

V. Phone/Fax

Practice location:
  • Phone: 402-291-1203
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number101718
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: