Kissell, Susan Lee
Kissell, Susan Lee is an sole proprietor health care provider with primary practice located at 401 Carlson Parkway , Minnetonka MN 55305-5387. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Kissell, Susan Lee can be contacted via phone (952) 992-3612.Contact Information
Primary practice address
401 Carlson Parkway
Minnetonka MN 55305-5387
Phone: (952) 992-3612
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | R0665283 | Minnesota |
Profile Details
| NPI number | 1245249259 |
|---|---|
| LBN Legal business name | Kissell, Susan Lee |
| Credentials | RN, CNP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 7th, 2006 |
| Last updated | Sep 2nd, 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 | 1245249259 | NPPES |
| Minnesota | MEDICAID | 1145878-00 |
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