Individual
MRS. CAROLYN D. KISSIAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
37 RUSTIC CAMPUS DRIVE, SOUTHERN SEVEN HEALTH DEPARTMENT, ULLIN, IL 62992-2226
(618) 634-2297
(618) 634-9011
Mailing address
37 RUSTIC CAMPUS DRIVE, ULLIN, IL 62992-2226
(618) 634-2297
(618) 634-9011
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041244469
IL
207VG0400X
Gynecology Physician
Primary
209001132
IL
Other
Enumeration date
03/24/2010
Last updated
03/24/2010
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