Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 227414 | OH |
NPI | 1003138611 |
---|---|
Provider Name | Sonia L Hissett |
First Address | Cleves, IN 45002-0000 |
Second Address | Cincinnati, OH 45238-2316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2010 |
Last Update Date | 23/02/2010 |