Individual
MRS. SUSAN FLEMING KISTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
GNP
Contact information
Practice address
508 FULTON STREET, DURHAM, NC 27705
(919) 416-5969
Mailing address
2500 LANIER PLACE, DURHAM, NC 27705
(919) 490-1040
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
111065
NC
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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