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NPI Code Detail

MEDICARE: CHRISTA KIESSEL MSN, RN, CS, AOCNP

MEDICARE: CHRISTA KIESSEL MSN, RN, CS, AOCNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner4704192243MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467418392
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTA KIESSEL MSN, RN, CS, AOCNP
Provider Business Mailing Address
First Line : 2513 MOMENTUM PL
Second Line :
City : CHICAGO
State : IL
Zip : 60689-5325
Country : US
Telephone Number : 231-935-6080
Fax Number : 231-935-6081
Provider Business Practice Location Address
First Line : 217 S MADISON STREET
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-2320
Country : US
Telephone Number : 231-392-8400
Fax Number : 231-935-7888
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2006
Last Update Date : 07/21/2022

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