Individual
LAURA KEEL SISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
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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