Individual
SHANNON C KISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
65 HOSPITAL DR, CORNWELL CENTER, ATHENS, OH 45701-2302
(740) 566-4890
(740) 566-4891
Mailing address
65 HOSPITAL DR, CORNWELL CENTER, ATHENS, OH 45701-2302
(740) 566-4890
(740) 566-4891
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10947-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3014017
—
OH
Enumeration date
10/06/2009
Last updated
09/01/2010
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