Healthcare Provider Details

I. General information

NPI: 1104760206
Provider Name (Legal Business Name): PARKER NEUROSCIENCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17940 WELCH PLZ STE 106
OMAHA NE
68135-3714
US

IV. Provider business mailing address

17940 WELCH PLZ STE 106
OMAHA NE
68135-3714
US

V. Phone/Fax

Practice location:
  • Phone: 402-915-1862
  • Fax:
Mailing address:
  • Phone: 402-915-1862
  • Fax: 402-817-3761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. LISA KOLLASCH PARKER
Title or Position: OWNER/CLINIC DIRECTOR
Credential: NP
Phone: 402-915-1862