| Doctor Name: | MRS. LISA A EDEAL |
| NPI Number: | 1548417298 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD |
| License Number: | 641 |
| Business Practice Address: | 2200 H St Fairbury, NE - 683521119 |
| Business Phone Number: | 4027296846 |
| Business Fax Number: | |
| Mailing Address: | 2200 H St, Po Box 277 FAIRBURY |
| State: | NE |
| Postal Code: | 683521119 |
| Phone Number: | 4027296846 |
| Fax Number: | |
| NPI Enumeration Date: | 08/25/2008 |
| NPI Last Update Date: | 12/28/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133NN1002X |
| License Number: | 641 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Nutritionist |
| Taxonomy Specialization: | Nutrition, Education |
| Taxonomy Definition: | |