Individual
KATHLEEN WILLIAMS NISSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-3241
(919) 784-6862
Mailing address
PO BOX 18139, RALEIGH, NC 27619-8139
(919) 784-3241
(919) 784-6862
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2011-01231
NC
207L00000X
Anesthesiology Physician
97347
GA
Other
Enumeration date
06/12/2007
Last updated
10/31/2023
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