Provider Demographics
NPI:1023162393
Name:EISENMENGER, LISA ANN BERGT (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:ANN BERGT
Last Name:EISENMENGER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:ANN
Other - Last Name:BERGT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:940 BEEMER CIR
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:NE
Mailing Address - Zip Code:68788-1955
Mailing Address - Country:US
Mailing Address - Phone:402-312-0617
Mailing Address - Fax:
Practice Address - Street 1:THE NEBRASKA MEDICAL CTR
Practice Address - Street 2:987565 NEBRASKA MEDICAL CENTER
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-0001
Practice Address - Country:US
Practice Address - Phone:402-552-3330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist