Kenneth William Nissen, ANP
NPI #1043659980 in Port Jefferson, New York
Provider Information
- NPI Number
- 1043659980
- Entity Type
- Individual
- Name
- Kenneth William Nissen, ANP
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Nurse Practitioner - Adult Health
- Credential
- ANP
- Enumeration Date
- Jun 24, 2013
- Last Updated
- Jun 24, 2013
Practice Location
- Address
- 75 N COUNTRY RD
- City
- Port Jefferson
- State
- New York
- ZIP Code
- 11777-2119
- Phone
- (631) 476-2786
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Adult Health — Adult Health |
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