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General NPI Number Information
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NPI Number | 1942054960
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Entity Type | Individual
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Provider Name | MARISSA-ASHLEY KISS MS, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/16/2024
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 955 N 21ST ST
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City | NEWARK
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State | OH
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Zip | 43055-2921
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Country | US
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Telephone | 614-491-8137
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Fax |
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Provider Business Mailing Address
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Address Line | 955 N 21ST ST
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City | NEWARK
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State | OH
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Zip | 43055-2921
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Country | US
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Telephone | 614-491-8137
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN.473550
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License Number State | OH
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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 | APRN.CNP.0036959
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License Number State | OH
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