Provider Demographics
NPI:1164217980
Name:CISSELL, SLOANE ALEXANDRA (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:SLOANE
Middle Name:ALEXANDRA
Last Name:CISSELL
Suffix:
Gender:X
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 1:6309 CASTLE HWY
Mailing Address - Street 2:
Mailing Address - City:PLEASUREVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40057-8733
Mailing Address - Country:US
Mailing Address - Phone:502-257-3963
Mailing Address - Fax:
Practice Address - Street 1:6309 CASTLE HWY
Practice Address - Street 2:
Practice Address - City:PLEASUREVILLE
Practice Address - State:KY
Practice Address - Zip Code:40057-8733
Practice Address - Country:US
Practice Address - Phone:502-257-3963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4037811363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily