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Individual

LAURA KEEL SISSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGACNP

Contact information

Practice address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(513) 475-8282
Mailing address
2830 VICTORY PKWY, CINCINNATI, OH 45206-1785

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0029160
OH
363LA2100X
Acute Care Nurse Practitioner
1-175582
AL

Other

Enumeration date
11/21/2019
Last updated
07/29/2021
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