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General NPI Number Information
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NPI Number | 1558405753
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Entity Type | Individual
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Provider Name | CYNTHIA KAY KIESEL FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 11/26/2019
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Provider Practice Location Address
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Address Line | 3838 N 1ST AVE # C
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City | EVANSVILLE
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State | IN
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Zip | 47710-3326
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Country | US
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Telephone | 812-402-8808
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 13059
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City | BELFAST
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State | ME
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Zip | 04915-4021
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71002188A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 71002188A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 71002188A
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License Number State | IN
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