Provider Demographics
NPI:1083737779
Name:MAPSON, LISA R (PHYSICIANS ASSISTANT)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:R
Last Name:MAPSON
Suffix:
Gender:F
Credentials:PHYSICIANS ASSISTANT
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:R
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PAC LICENSE # 489
Mailing Address - Street 1:1001 S 70TH STREET
Mailing Address - Street 2:ROBERT D PLAMBECK MD PC SUITE 220
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510
Mailing Address - Country:US
Mailing Address - Phone:402-486-4800
Mailing Address - Fax:402-486-1459
Practice Address - Street 1:1001 S 70TH STREET
Practice Address - Street 2:ROBERT D PLAMBECK MD PC SUITE 220
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510
Practice Address - Country:US
Practice Address - Phone:402-486-4800
Practice Address - Fax:402-486-1459
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE489363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
37856OtherBCBS OF NE