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Individual
LAUREN MICHELLE KISSOCK
Active
Individual
LAUREN MICHELLE KISSOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-S
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA14137
TX
363A00000X
Physician Assistant
Primary
PA9122313
FL
363AS0400X
Surgical Physician Assistant
PA14137
TX
363AS0400X
Surgical Physician Assistant
PA9122313
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
PA14137
TX
Other
Enumeration date
02/19/2020
Last updated
10/01/2026
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