Kiessling, Mark
Kiessling, Mark is an individual health care provider with primary practice located at 1 Medical Center Dr , Lebanon NH 03756-1000. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Kiessling, Mark can be contacted via phone (603) 650-7840.Contact Information
Primary practice address
1 Medical Center Dr
Lebanon NH 03756-1000
Phone: (603) 650-7840
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 0500 | New Hampshire |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 00324 | Connecticut |
Profile Details
| NPI number | 1609810555 |
|---|---|
| LBN Legal business name | Kiessling, Mark |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 15th, 2006 |
| Last updated | Oct 31st, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609810555 | NPPES |
| New Hampshire | MEDICAID | 30332778 | |
| New Hampshire | MEDICAID | 9000180 |
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