Individual
VIRGINIA CAROL SISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1505 E CHURCHVILLE RD, BEL AIR, MD 21014-4742
(410) 420-6970
Mailing address
161 LONG DR, ELKTON, MD 21921-3691
(443) 553-5102
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R130847
MD
Other
Enumeration date
10/25/2016
Last updated
10/25/2016
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