Provider Demographics
NPI:1437510757
Name:SELL, ANISSA LYNN (APRN)
Entity Type:Individual
Prefix:
First Name:ANISSA
Middle Name:LYNN
Last Name:SELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 41ST DR
Mailing Address - Street 2:
Mailing Address - City:CHANUTE
Mailing Address - State:KS
Mailing Address - Zip Code:66720-7401
Mailing Address - Country:US
Mailing Address - Phone:620-433-1806
Mailing Address - Fax:620-365-7717
Practice Address - Street 1:3066 N KENTUCKY ST
Practice Address - Street 2:
Practice Address - City:IOLA
Practice Address - State:KS
Practice Address - Zip Code:66749
Practice Address - Country:US
Practice Address - Phone:620-365-1185
Practice Address - Fax:620-365-1038
Is Sole Proprietor?:No
Enumeration Date:2016-03-14
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS77175363L00000X
KSF0316302364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner