Individual
MISS KITTY BONITA SISK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2402 OSLER CT, ALBANY, GA 31707-0205
(229) 438-3300
Mailing address
2402 OSLER CT, ALBANY, GA 31707-0205
(229) 438-3300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2198
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0100001200A
—
GA
01
—
970020094
RAILROAD MEDICARE
GA
Enumeration date
01/10/2007
Last updated
06/07/2022
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