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KELLY SISSON AGACNP NPI 1225604093


NPI Information

NPI: 1225604093
Provider Name: KELLY SISSON, AGACNP
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

PECOS Registration: Yes

Address:
575 PROFESSIONAL DR STE 400
LAWRENCEVILLE, GA
ZIP 30046
Phone: (404) 962-6000
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Kelly Sisson, AGACNP is an acute care nurse practitioner in Lawrenceville, GA with 4 years of experience. Kelly Sisson, AGACNP NPI is 1225604093. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE
Graduation Year:2020

The provider's business location address is:

575 PROFESSIONAL DR STE 400
LAWRENCEVILLE, GA
ZIP 30046-335
Phone: (404) 962-6000
Fax: (404) 962-6001

The NPI 1225604093 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/2/2021 and was last updated on 6/2/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LA2100XNurse PractitionerAcute CareRN191117GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.