Individual
MICHELLE ANN NISSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AG-ACNP
Contact information
Practice address
1530 NEEDMORE RD STE 300, DAYTON, OH 45414-3980
(937) 277-4274
(937) 277-8476
Mailing address
1530 NEEDMORE RD STE 300, DAYTON, OH 45414-3980
(937) 277-4274
(937) 277-8476
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
COA.17492-NP
OH
Other
Enumeration date
06/24/2015
Last updated
07/15/2015
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