Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lisa K Nielsen, PA-C

Individual provider Surgical Physician Assistant · NPI 1982688669

Lisa K Nielsen, PA-C is a Surgical Physician Assistant in Peoria, Illinois. Licensed in Illinois. Registered with an NPI since 2005.

Licensed in
IL
In the registry since
2005
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

7309 N Knoxville Ave
Peoria, IL 61614-2085
Phone: (309) 692-9898
Fax: (309) 692-9055
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 85000333 (IL)

Record details

NPI number1982688669
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 6, 2005
Last updated in NPPESFebruary 25, 2020
Certification dateFebruary 25, 2020

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