Individual
MS. KRISTEN M BISSETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
1811 FOREST HILLS RD W, WILSON, NC 27893-3412
(252) 243-7400
(252) 243-3291
Mailing address
12150 CAMP CHARLES ROAD, BAILEY, NC 27807
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4986
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0777Y
BCBS
NC
05
—
720777Y
—
NC
Enumeration date
06/11/2008
Last updated
06/11/2008
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