Individual
LISA A KISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
85 LAFAYETTE ST, NEW BRITAIN, CT 06051-1803
(860) 224-3642
(860) 224-2760
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-8021
(860) 679-4477
(860) 679-1017
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1054593
KY
363L00000X
Nurse Practitioner
5673P
KY
363LF0000X
Family Nurse Practitioner
Primary
008855
CT
363LF0000X
Family Nurse Practitioner
3005673
KY
363LF0000X
Family Nurse Practitioner
5673P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100058130
—
KY
Enumeration date
09/11/2008
Last updated
04/22/2025
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