Individual
KASEY SISSOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
200 EVITT PKWY, RINGGOLD, GA 30736-3183
(706) 581-5449
Mailing address
200 EVITT PKWY, RINGGOLD, GA 30736-3183
(706) 581-5449
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
RN185647
GA
Other
Enumeration date
02/11/2013
Last updated
03/11/2019
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