Provider Demographics
NPI:1255609632
Name:KISSELL, ERICA J (CRNP)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:J
Last Name:KISSELL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3 WALNUT ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LEMOYNE
Mailing Address - State:PA
Mailing Address - Zip Code:17043-1168
Mailing Address - Country:US
Mailing Address - Phone:717-761-0208
Mailing Address - Fax:717-761-2023
Practice Address - Street 1:425 N 21ST ST
Practice Address - Street 2:SUITE 102
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2223
Practice Address - Country:US
Practice Address - Phone:717-972-2829
Practice Address - Fax:717-695-8722
Is Sole Proprietor?:No
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PASP011809363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner