Individual
KELLY SISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
575 PROFESSIONAL DR STE 400, LAWRENCEVILLE, GA 30046-3335
(404) 962-6000
(404) 962-6001
Mailing address
575 PROFESSIONAL DR STE 400, LAWRENCEVILLE, GA 30046-3335
(404) 962-6000
(404) 962-6001
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN191117
GA
Other
Enumeration date
06/02/2021
Last updated
06/02/2021
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