Individual
AWA CISSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2050 LEXINGTON RD, VERSAILLES, KY 40383-1738
(859) 251-4700
Mailing address
3779 KENSINGTON DR, DANVILLE, IN 46122-6000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28245308A
IN
Other
Enumeration date
04/20/2026
Last updated
04/20/2026
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