Individual
JENNIFER SISCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
55 CARLTON ST, ATHENS, GA 30602-1407
(706) 542-2273
(706) 542-8661
Mailing address
55 CARTON ST, ATHENS, GA 30602-0001
(706) 542-2273
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
A004547
AR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN274159
GA
Other
Enumeration date
10/05/2015
Last updated
08/11/2022
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