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Individual

MARIAH NICOLE SISSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 384-6440
(319) 384-6295
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 384-6440
(319) 384-6295

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
72349
MN
208000000X
Pediatrics Physician
Primary
MD-53654
IA
2080S0010X
Pediatric Sports Medicine Physician
72349
MN
2080S0010X
Pediatric Sports Medicine Physician
MD-53654
IA

Other

Enumeration date
06/05/2018
Last updated
11/15/2024
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