Individual
DR. AMY LYNETTE KISNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2647 S SAINT ELIZABETH BLVD STE 308, GONZALES, LA 70737-5020
(225) 765-5500
(225) 765-9419
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 765-5500
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
19549
WV
207R00000X
Internal Medicine Physician
Primary
MD.204734
LA
208000000X
Pediatrics Physician
19549
WV
208000000X
Pediatrics Physician
MD.204734
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2165640
—
LA
01
—
P00009580
RAILROAD MEDICARE
—
Enumeration date
07/29/2005
Last updated
12/05/2025
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