Healthcare Provider Details

I. General information

NPI: 1023063146
Provider Name (Legal Business Name): ANNE M. LISKA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNE M. LAMBERT PA-C

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 03/19/2021
Certification Date: 03/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 21ST CIRCLE
WISNER NE
68791-2045
US

IV. Provider business mailing address

500 E DECATUR ST
WEST POINT NE
68788-1566
US

V. Phone/Fax

Practice location:
  • Phone: 402-529-6516
  • Fax: 402-529-6530
Mailing address:
  • Phone: 402-372-2404
  • Fax: 402-372-6770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number458
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: