MEDICARE: LISA R RAUNER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	19873	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770547168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA R RAUNER MD

Provider Business Mailing Address
First Line	:	1600 S 48TH ST
Second Line	:	STE 400
City	:	LINCOLN
State	:	NE
Zip	:	68506-1275
Country	:	US
Telephone Number	:	402-475-8877
Fax Number	:	402-475-8941

Provider Business Practice Location Address
First Line	:	1600 S 48TH ST
Second Line	:	STE 400
City	:	LINCOLN
State	:	NE
Zip	:	68506-1275
Country	:	US
Telephone Number	:	402-475-8877
Fax Number	:	402-475-8941

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	09/30/2010

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Directions to “ LISA R RAUNER MD” Practice Location

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