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General NPI Number Information
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NPI Number | 1417188285
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Entity Type | Individual
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Provider Name | BENJAMIN LUKE KISER ARNP
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Gender | Male
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Dates
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Enumeration Date | 07/28/2009
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Last Update Date | 09/23/2022
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Provider Practice Location Address
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Address Line | 214 HIGHWAY 3086
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City | JENKINS
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State | KY
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Zip | 41537-9204
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Country | US
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Telephone | 606-212-1131
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Fax | 606-212-1195
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Provider Business Mailing Address
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Address Line | 214 HIGHWAY 3086
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City | JENKINS
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State | KY
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Zip | 41537-9204
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Country | US
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Telephone | 276-212-1131
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Fax | 276-212-1195
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 47901
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024172025
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License Number State | VA
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