| Waybridge Pc | |
|
17021 Lakeside Hills Plaza Suite 203 Omaha NE 68130 | |
| (402) 965-1371 | |
| Not Available |
| Full Name | Waybridge Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 17021 Lakeside Hills Plaza, Omaha, Nebraska |
| Authorized Official Name and Position | Branson Horn (COO) |
| Authorized Official Contact | 2054150858 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waybridge Pc 17021 Lakeside Hills Plaza Suite 203 Omaha NE 68130 Ph: () - | Waybridge Pc 17021 Lakeside Hills Plaza Suite 203 Omaha NE 68130 Ph: (402) 965-1371 |
| NPI Number | 1386408383 |
|---|---|
| Provider Enumeration Date | 02/09/2024 |
| Last Update Date | 12/03/2025 |
| Certification Date | 12/03/2025 |
| Medicare PECOS PAC ID | 5092230003 |
|---|---|
| Medicare Enrollment ID | O20250422002355 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386408383 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Lisa K Kollasch Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306897863 PECOS PAC ID: 6103889522 Enrollment ID: I20050908000348 |
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