Individual
KRYN L SISCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC, MPA,BSN RN
Contact information
Practice address
812 E JOLLY RD, STE 216, LANSING, MI 48910-6818
(517) 346-9554
(517) 346-8291
Mailing address
101 W TOWNSEND RD, SAINT JOHNS, MI 48879-9200
(989) 403-6100
(989) 403-6120
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704152662
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245296326
—
MI
Enumeration date
04/26/2006
Last updated
01/24/2022
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