Individual
MS. ANNETTE M KISSIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102
(207) 662-2246
(207) 662-6227
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
F350360
NY
363LN0000X
Neonatal Nurse Practitioner
Primary
R032022
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03774449
—
NY
Enumeration date
12/11/2006
Last updated
07/24/2018
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