Provider Demographics
NPI:1003867466
Name:YOSTEN, LISA D (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:D
Last Name:YOSTEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 W NORFOLK AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-4438
Mailing Address - Country:US
Mailing Address - Phone:402-371-4880
Mailing Address - Fax:402-644-7510
Practice Address - Street 1:2700 W NORFOLK AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4438
Practice Address - Country:US
Practice Address - Phone:402-371-4880
Practice Address - Fax:402-644-7510
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE22455207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA5299776Medicaid
NE276732Medicare PIN
NE30935OtherBCBS
NE39-01614OtherSHAREADVANTAGE
IA0299776Medicaid
NE100249951-00Medicaid
IA4299776Medicaid
IAI11543Medicare PIN
IA34949OtherWELLMARK FOR IOWA
IAP00091719OtherRRCARE FOR IOWA
IAH61102Medicare UPIN
NE240658OtherMIDLANDS CHOICE
IA01306OtherBCBSNE FOR IOWA
IA240658OtherMIDLANDS CHOICE IOWA
IA39-01620OtherSHARE ADVANTAGE IOWA
IA3901617OtherSHARE ADVANTAGE
NE100251217-00Medicaid
NE100251147-00Medicaid