Individual
MISS KATIE T KISSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
128 E PLAZA DR STE 3, MOORESVILLE, NC 28115-8000
(980) 444-2630
Mailing address
PO BOX 896199, CHARLOTTE, NC 28289-6199
(833) 936-1364
(605) 942-7505
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5012800
NC
Other
Enumeration date
02/03/2020
Last updated
10/14/2020
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