Lookup NPI Numbers from the NPI Registry
NPI Profile for KENNETH W NISSEN in PORT JEFFERSON, NY.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Adult Health |
363LA2200X | 50 | Nurse Practitioner |
| NPI # | 1043659980 |
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| Status | Active | |
| Credentials | ANP (Adult Nurse Practitioner) | |
| Entity | Individual | |
| Enumeration date | 06/24/2013 | |
| Last updated | 06/24/2013 - About 13 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
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| Hospital affiliation(s) |
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KENNETH W NISSEN
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KENNETH W NISSEN, ANP