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General NPI Number Information
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NPI Number | 1922449065
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Entity Type | Individual
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Provider Name | DESIRE L AYISSI
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Gender | Male
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Dates
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Enumeration Date | 07/16/2013
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 5319 LEES CROSSING DR APT 2
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City | CINCINNATI
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State | OH
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Zip | 45239-7684
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Country | US
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Telephone | 513-328-5933
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Fax |
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Provider Business Mailing Address
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Address Line | 5319 LEES CROSSING DR APT 2
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City | CINCINNATI
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State | OH
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Zip | 45239-7684
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Country | US
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Telephone | 513-328-5933
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP61531156
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 386099
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License Number State | OH
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