| Doctor Name: | LISA M MORAVAC |
| NPI Number: | 1003997925 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 2005022710 |
| Business Practice Address: | 1509 W Truman Rd Independence, MO - 640503436 |
| Business Phone Number: | 8168366901 |
| Business Fax Number: | 8168364460 |
| Mailing Address: | Po Box 838, SHAWNEE MISSION |
| State: | KS |
| Postal Code: | 662010838 |
| Phone Number: | 9134694244 |
| Fax Number: | 9134691939 |
| NPI Enumeration Date: | 10/18/2006 |
| NPI Last Update Date: | 01/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 2005022710 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |