Provider Demographics
NPI:1114542461
Name:SISSON, CHESNEY SIMS (FNP)
Entity Type:Individual
Prefix:
First Name:CHESNEY
Middle Name:SIMS
Last Name:SISSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 N MCKINNEY ST
Mailing Address - Street 2:
Mailing Address - City:SWEENY
Mailing Address - State:TX
Mailing Address - Zip Code:77480-2801
Mailing Address - Country:US
Mailing Address - Phone:979-548-1500
Mailing Address - Fax:
Practice Address - Street 1:305 N MCKINNEY ST
Practice Address - Street 2:
Practice Address - City:SWEENY
Practice Address - State:TX
Practice Address - Zip Code:77480-2801
Practice Address - Country:US
Practice Address - Phone:979-548-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1002580363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily