Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 110478 | NE |
NPI | 1013081561 |
---|---|
Provider Name | Ms. Lisa M Halbur |
First Address | Omaha, NE 68114-4113 |
Second Address | Omaha, NE 68114-4113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 08/07/2007 |