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General NPI Number Information
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NPI Number | 1063204535
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Entity Type | Individual
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Provider Name | COURTNEY KISSEL PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 10547 MONTGOMERY RD # 700
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City | MONTGOMERY
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State | OH
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Zip | 45242-4418
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Country | US
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Telephone | 888-830-0347
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Fax |
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Provider Business Mailing Address
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Address Line | 1670 COLLINSDALE AVE
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City | CINCINNATI
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State | OH
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Zip | 45230-2247
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Country | US
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Telephone | 513-659-0762
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0038973
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License Number State | OH
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