MEDICARE: DR. MEGAN LAWLESS KLIESNER M.D.

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	7813	NE

General Provider Information

NPI Number	:	1932550647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEGAN LAWLESS KLIESNER M.D.

Provider Business Mailing Address
First Line	:	983135 NEBRASKA MEDICAL CTR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68198-3135
Country	:	US
Telephone Number	:	402-559-7726
Fax Number	:	402-559-6018

Provider Business Practice Location Address
First Line	:	2741 E LAS VEGAS ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-1594
Country	:	US
Telephone Number	:	719-390-2450
Fax Number	:	719-390-2462

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

Provider Enumeration Date	:	06/23/2016
Last Update Date	:	01/25/2022

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