Healthcare Provider Details

I. General information

NPI: 1538093265
Provider Name (Legal Business Name): YANA KISIC A.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 GORDON DR
NAPLES FL
34102-7879
US

IV. Provider business mailing address

421 MEADOWLARK LN UNIT B
NAPLES FL
34105-2980
US

V. Phone/Fax

Practice location:
  • Phone: 239-261-7615
  • Fax:
Mailing address:
  • Phone: 267-231-2226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number4652
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: