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MRS. KERISSA MEETTA DEESE PA-C

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1598396996

Individual Registrant:
MRS. KERISSA MEETTA DEESE PA-C
Gender: F
Sole Proprietor

Location and contact information for practice:
3700 S RAILROAD ST STE A  PHENIX CITY, AL 36867-2994 US
Tel: 334-664-0463  Fax: --

Contact information for business:
8912 THOMPSON RIDGE LOOP  MONTGOMERY, AL 36117-8957 US
Tel: 334-413-1660  Fax: --

Registration Information:
NPI: 1598396996
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
AL1552

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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