Provider Demographics
NPI:1598808347
Name:SINDELAR-OVERLEESE, LISA (RRT)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:SINDELAR-OVERLEESE
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 122
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:NE
Mailing Address - Zip Code:68920-0122
Mailing Address - Country:US
Mailing Address - Phone:308-928-9999
Mailing Address - Fax:308-928-9999
Practice Address - Street 1:101 N JOHN
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:NE
Practice Address - Zip Code:68920-0122
Practice Address - Country:US
Practice Address - Phone:308-928-9999
Practice Address - Fax:308-928-9999
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE614332BX2000X
332BX2000X
KS16-00261332BX2000X
KS5-03020332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE36960OtherBLUE CROSS BLUE SHIELD
KS200307550AMedicaid
NE$$$$$$$$$00Medicaid
NE$$$$$$$$$00Medicaid