Provider Demographics
NPI:1730401779
Name:KAISER, LINDSEY J (PAC)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:J
Last Name:KAISER
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:J
Other - Last Name:NOVAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:4239 FARNAM ST
Mailing Address - Street 2:#301
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2868
Mailing Address - Country:US
Mailing Address - Phone:402-552-3040
Mailing Address - Fax:402-552-3043
Practice Address - Street 1:4239 FARNAM ST
Practice Address - Street 2:#301
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2868
Practice Address - Country:US
Practice Address - Phone:402-552-3040
Practice Address - Fax:402-552-3043
Is Sole Proprietor?:No
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1498363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant