Provider Demographics
NPI:1730712605
Name:SISSELL, CHRISTOPHER AARON (NP-C)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:AARON
Last Name:SISSELL
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 GAUSE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2949
Mailing Address - Country:US
Mailing Address - Phone:985-280-8900
Mailing Address - Fax:985-280-2618
Practice Address - Street 1:901 GAUSE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2949
Practice Address - Country:US
Practice Address - Phone:985-280-8900
Practice Address - Fax:985-280-2618
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA211621363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care