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Individual

AMY M. CISSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1000 DUPONT RD, LOUISVILLE, KY 40207-4611
(502) 899-6405
(502) 889-6407
Mailing address
PO BOX 766351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5181P
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000631045
ANTHEM - NHWM
KY
01
000051983Y
HUMANA - NHWM
KY
01
107785
SIHO - NHWM
KY
05
200928570
IN
01
2592936
CIGNA - NHWM
KY
01
3749683000
PASSPORT ADVTG - NHWM
KY
01
50026597
PASSPORT - NHWM
KY
05
7100071580
KY
01
P00948795
RAILROAD MEDICARE - KY - NHWM
KY
Enumeration date
07/02/2006
Last updated
10/13/2020
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