Provider Demographics
NPI:1023063146
Name:LISKA, ANNE M (PA-C)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:M
Last Name:LISKA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:M
Other - Last Name:LAMBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:500 E DECATUR ST
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:NE
Mailing Address - Zip Code:68788-1566
Mailing Address - Country:US
Mailing Address - Phone:402-372-2404
Mailing Address - Fax:402-372-6770
Practice Address - Street 1:2100 21ST CIRCLE
Practice Address - Street 2:
Practice Address - City:WISNER
Practice Address - State:NE
Practice Address - Zip Code:68791-2045
Practice Address - Country:US
Practice Address - Phone:402-529-6516
Practice Address - Fax:402-529-6530
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE458363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI15926Medicare PIN
NE278199Medicare PIN
R29895Medicare UPIN