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Individual

NANCY J MCKISSICK

Active
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Individual

NANCY J MCKISSICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9467071
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000331132
BLUE CROSS BLUE SHIELD
IN
05
100082060
IN
05
200373280C
IN
01
JG949Z
MEDICARE
FL
Enumeration date
08/12/2005
Last updated
08/13/2020
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