Kristie N Sisson, RN
Individual provider Active NPI Registered Nurse · Millersport, OH
NPI 1467782011 · NPPES record last updated Jan 4, 2010
Key facts
- NPI
- 1467782011
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 330233 (OH)
- Practice address
- 12370 Wolfe Blvd
Millersport, OH 43046-7000 - Phone
- (740) 467-2504
- NPI assigned
- Jan 4, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 330233 | OH | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 330233 | OH | Yes |
Addresses
Primary practice location
12370 Wolfe Blvd
Millersport, OH 43046-7000
Mailing address
12370 Wolfe Blvd
Millersport, OH 43046-7000
Phone (740) 467-2504
Other providers in Millersport, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.