NPI 1639839137
Richard Lee Kissack
Practice location
- Address
- 1811 W. 2nd St. Suite 450, Grand Island, NE 68803-7543
- Phone
- (308) 379-8619
- Mailing address
- 1811 W. 2nd St. Suite 450, Grand Island, NE 68803-5473
Registered specialties
Community/Behavioral Health Agency
Primary
Registry record
- NPI
- 1639839137
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 23 Dec 2021
- Record last updated
- 23 Dec 2021
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.