Jill Amoret Sisson, RN,NNP

Primary specialty

Neonatal Intensive Care Registered NurseTaxonomy code 163WN0002X

License

093032 Issued in MO

Practice address

10010 Kennerly Rd
Saint Louis, MO 63128-2106

Phone

(314) 525-4859

NPI assigned

Nov 23, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Jill Amoret Corley-Bangert Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871668756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7820 STATE ROUTE 4",
            "city": "WORDEN",
            "state": "IL",
            "postal_code": "620972042",
            "telephone_number": "618-633-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 KENNERLY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282106",
            "telephone_number": "314-525-4859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISSON",
        "first_name": "JILL",
        "middle_name": "AMORET",
        "name_prefix": "Mrs.",
        "credential": "RN,NNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "MO",
            "license": "093032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "CORLEY-BANGERT",
            "middle_name": "AMORET",
            "prefix": "MRS.",
            "credential": "RN,NNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bryan Anthony Sisk, MD
• Kristi Ann Sisk
• Savannah Sisk, OTR/L
• Donald R. Sislen, M.D.
• Patricia Ann Sissac
• Sarah Sisson, MSN, PMHNP
• Stacy Jane Sisson, R.N.
• Sister to Sister Health Care Services LLC
• Sisterly Love Home Care, LLC
• Sisters Care Home Services LLC

• Neonatal Intensive Care Registered Nurse in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Neonatal Intensive Care Registered Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.