Healthcare Provider Details

I. General information

NPI: 1225253636
Provider Name (Legal Business Name): LISA R. FUCHS MHA, RRT, CTTS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 02/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15087 BIRCH ST
OMAHA NE
68116-6176
US

IV. Provider business mailing address

15087 BIRCH ST
OMAHA NE
68116-6176
US

V. Phone/Fax

Practice location:
  • Phone: 402-960-2903
  • Fax:
Mailing address:
  • Phone: 402-960-2903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number603
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: