Individual provider · Type 1 NPI
Mavis Kisseadoo, PMHNP
Psychiatric/Mental Health Nurse Practitioner · Columbia, MD
NPI number
1366081887
Active
Practice location
10208 Hickory Ridge Rd Apt 302
Columbia, MD 21044-4688
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | R205356 (MD) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1366081887
Mavis Kisseadoo, PMHNP's National Provider Identifier is 1366081887, issued on Jan 1, 2020. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Columbia, MD. The record was last updated on Jan 1, 2020.