Individual
LAURENT NARCISSE KISSOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2209 OLCOTT AVE, ARDMORE, PA 19003-2920
(267) 815-2920
Mailing address
2209 OLCOTT AVE, ARDMORE, PA 19003-2920
(267) 815-2920
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
SP035790
PA
Other
Enumeration date
04/17/2026
Last updated
04/17/2026
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