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General NPI Number Information
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NPI Number | 1922257278
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Entity Type | Individual
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Provider Name | LISA A KISE FNP
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Gender | Female
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Dates
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Enumeration Date | 09/11/2008
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 85 LAFAYETTE ST
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City | NEW BRITAIN
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State | CT
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Zip | 06051-1803
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Country | US
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Telephone | 860-224-3642
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Fax | 860-224-2760
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Provider Business Mailing Address
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Address Line | 263 FARMINGTON AVE
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City | FARMINGTON
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State | CT
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Zip | 06030-8021
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Country | US
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Telephone | 860-679-4477
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Fax | 860-679-1017
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1054593
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5673P
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5673P
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3005673
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 008855
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License Number State | CT
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