Individual ProviderLisa A LedlNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1257 Paiute Cir, Las Vegas, NV 89106-3202(702) 382-0784PECOS EnrollmentThis provider is enrolled in PECOS as LISA LEDL.Based on the most recent information from CMS, provider Lisa A Ledl is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1568433217Provider TypeIndividualFull NameLedl, Lisa ATitleMrs.CredentialAPNGenderFemaleSole ProprietorYesEnumeration Date1/31/2006Last Updated6/28/2022Contact InformationPractice LocationPractice Address1257 Paiute Cir, Las Vegas, NV 89106-3202Phone(702) 382-0784Fax(702) 384-5272Mailing LocationMailing Address1257 Paiute Cir, Las Vegas, NV 89106-3202Phone(702) 382-0784Fax(702) 384-5272Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPN00298NevadaProvider IdentifiersIDDescriptionIssuerID2402305DescriptionMedicaidIssuerUnlistedNevadaID3102305DescriptionMedicaidIssuerUnlistedNevada