Provider Demographics
NPI:1710610589
Name:CISSET, FATOU (NP)
Entity Type:Individual
Prefix:MISS
First Name:FATOU
Middle Name:
Last Name:CISSET
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-5007
Mailing Address - Country:US
Mailing Address - Phone:508-308-3801
Mailing Address - Fax:
Practice Address - Street 1:806 WINDSOR DR
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-5007
Practice Address - Country:US
Practice Address - Phone:508-308-3801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2278071163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health