Nissen, Michael D

Nissen, Michael D is an individual health care provider with primary practice located at 313 Teal Dr , Raeford NC 28376-2567. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Nissen, Michael D can be contacted via phone (910) 904-2350.

Contact Information

Primary practice address
313 Teal Dr Raeford NC 28376-2567
Phone: (910) 904-2350
Fax: (910) 904-1037
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 1061217 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 242756 North Carolina

Profile Details

NPI number 1417077827
LBN Legal business name Nissen, Michael D
Credentials N.P.-C
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2007
Last updated Oct 22nd, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417077827 NPPES
North Carolina MEDICAID 7004922

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