Provider Demographics
NPI:1811225717
Name:NISSLEY, KRISTI JO (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:JO
Last Name:NISSLEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2759 STATE ROAD 37
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:IN
Mailing Address - Zip Code:47446-6016
Mailing Address - Country:US
Mailing Address - Phone:812-992-5440
Mailing Address - Fax:812-992-5441
Practice Address - Street 1:2759 STATE ROAD 37
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:IN
Practice Address - Zip Code:47446
Practice Address - Country:US
Practice Address - Phone:812-849-6420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-03
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003156A363LF0000X
IN28160943A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily