MEDICARE: DR. AMY LYNETTE KISNER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	19549	WV
2	207R00000X	Internal Medicine Physician	19549	WV
3	207R00000X	Internal Medicine Physician	MD.204734	LA
4	208000000X	Pediatrics Physician	MD.204734	LA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00009580	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326048562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY LYNETTE KISNER MD

Provider Business Mailing Address
First Line	:	5959 S SHERWOOD FOREST BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-6038
Country	:	US
Telephone Number	:	225-765-5500
Fax Number	:	225-765-9196

Provider Business Practice Location Address
First Line	:	2647 S SAINT ELIZABETH BLVD STE 308
Second Line	:
City	:	GONZALES
State	:	LA
Zip	:	70737-5020
Country	:	US
Telephone Number	:	225-765-5500
Fax Number	:	225-765-9419

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	12/05/2025

Similar Medicare Providers

1104822774 — ROBERT P. ST. AMANT M.D.
Practice Location Address:

2647 S SAINT ELIZABETH BLVD STE 311
GONZALES, LA
70737-5020

Practice Phone: 225-743-2833
Practice Fax: 225-743-2074

1376522425 — MS. KELLY LINER DUKE P.A.
Practice Location Address:

2647 S SAINT ELIZABETH BLVD STE 125
GONZALES, LA
70737-5020

Practice Phone: 225-647-9675
Practice Fax: 225-766-2226

1629003793 — CHRIS G HAIK NP
Practice Location Address:

2647 S SAINT ELIZABETH BLVD STE 125
GONZALES, LA
70737-5020

Practice Phone: 225-647-9675
Practice Fax: 225-647-9676

1376743427 — DR. MICHAEL SHANE BODIN MD
Practice Location Address:

2647 S SAINT ELIZABETH BLVD STE 219
GONZALES, LA
70737-5020

Practice Phone: 225-765-5500
Practice Fax: 225-743-2620

1316100381 — MR. DAVID HENRY SEPULVEDA PA-C
Practice Location Address:

2647 S SAINT ELIZABETH BLVD STE 219
GONZALES, LA
70737-5020

Practice Phone: 225-647-8511
Practice Fax:

1609023944 — DR. MUDDASSIR SANA M.D
Practice Location Address:

2647 S SAINT ELIZABETH BLVD STE 220
GONZALES, LA
70737-5020

Practice Phone: 225-743-2345
Practice Fax: 225-743-2543

Directions to “ DR. AMY LYNETTE KISNER MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.