Provider Demographics
NPI:1417110594
Name:GRAFF, LISA KAY (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:KAY
Last Name:GRAFF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2304 GEORGETOWN PL
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-1050
Mailing Address - Country:US
Mailing Address - Phone:402-291-2780
Mailing Address - Fax:
Practice Address - Street 1:PULMONARY RESEARCH
Practice Address - Street 2:982465 NEBRASKA MEDICAL CTR
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-2465
Practice Address - Country:US
Practice Address - Phone:402-559-8915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE481363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant