Most Relevant Information
Provider Data
| NPI Number: | 1003390584 |
| Provider Name: | ELLEN FERN KISER |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 062500 |
Most Important Dates
| Enumeration Date: | 09/20/2018 |
| Last Updated: | 09/20/2018 |
Provider Practice Location
9863 E CENTER ST
WINDHAM
OH
442881039
Practice Location Phone/Fax
| Phone: | 3303077903 |
| Fax: | 3305433782 |
Provider Mailing Location
9863 E CENTER ST
WINDHAM
OH
442881039
Provider Mailing Phone/Fax
| Phone: | 3303077903 |
| Fax: | 3305433782 |