Individual
ELLEN MARY KISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN, IBCLC
Contact information
Practice address
19129 GREEN SPRINGS DR, EDMOND, OK 73012-9768
(405) 760-6931
Mailing address
19129 GREEN SPRINGS DR, EDMOND, OK 73012-9768
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
R63740
OK
Other
Enumeration date
07/19/2010
Last updated
07/19/2010
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