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NPI Code Detail

MEDICARE: THOMAS SISK FNP-BC

MEDICARE: THOMAS SISK FNP-BC
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
1363LF0000XFamily Nurse PractitionerA167770IA
2363LF0000XFamily Nurse PractitionerTPAN1361FL
3363LF0000XFamily Nurse Practitioner95023363CA
4363LF0000XFamily Nurse Practitioner50537WY
5363LF0000XFamily Nurse Practitioner23962SC

General Provider Information

NPI Number : 1538783139
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS SISK FNP-BC
Provider Business Mailing Address
First Line : 102 S 11TH ST
Second Line :
City : SAN JOSE
State : CA
Zip : 95112-2132
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 102 S 11TH ST
Second Line :
City : SAN JOSE
State : CA
Zip : 95112-2132
Country : US
Telephone Number : 307-620-9249
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2020
Last Update Date : 03/16/2026

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Directions to “ THOMAS SISK FNP-BC” Practice Location

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