Individual
GLORIA E MCKISSIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3450 W 34TH AVE, PINE BLUFF, AR 71603-5508
(870) 534-6067
(870) 534-7297
Mailing address
1 CHILDRENS WAY, SLOT 512-39, LITTLE ROCK, AR 72202-3500
(501) 364-3620
(501) 364-5192
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
16222
AR
Other
Enumeration date
12/20/2011
Last updated
12/20/2011
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