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General NPI Number Information
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NPI Number | 1114494887
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Entity Type | Individual
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Provider Name | LISA SEAMAN
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Gender | Female
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Dates
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Enumeration Date | 10/30/2018
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Last Update Date | 10/30/2018
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Provider Practice Location Address
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Address Line | 425 N DIERS AVE STE 3
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City | GRAND ISLAND
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State | NE
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Zip | 68803-4910
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Country | US
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Telephone | 308-381-4452
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Fax |
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Provider Business Mailing Address
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Address Line | 1704 HUDSON CIR
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City | GRAND ISLAND
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State | NE
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Zip | 68801-7473
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Country | US
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Telephone | 308-340-2081
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 2124
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License Number State | NE
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