Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | VP004297M | PA |
Y | 363LA2200X | Nurse Practitioner - Adult Health | VP004297M | PA |
NPI | 1013999762 |
---|---|
Provider Name | Ms. Connie D Kiser |
First Address | York, PA 17402-9001 |
Second Address | York, PA 17403-5049 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2005 |
Last Update Date | 03/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S60669 | (02) |