MS. KEVIN LYN SISSON (NPI# 1104372960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104372960 |
| Entity Type | Individual |
| Full Name | MS. KEVIN LYN SISSON |
| Practice Address |
417 Neponset Ave Boston MA 02122 |
| Mailing Address |
80 Jewett St Newton MA 02458-1524 |
| Practice Telephone | 8572173700 |
| Mailing Telephone | 3016933525 |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2016-08-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
417 NEPONSET AVE |
| City | BOSTON |
| State | MA |
| Zip Code | 02122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033720875 | Joey Mark Nguyen | Pharmacist | 747 Gallivan Blvd, Dorchester, MA 02122 | 2020-08-14 |
| 1518575240 | Hamilton Pharmacy LLC | Pharmacy | 246 Bowdoin St, Dorchester, MA 02122 | 2020-07-20 |
| 1336789528 | Katheline Leconte | Social Worker | 230 Bowdoin Street, Dorchester, MA 02122 | 2020-01-15 |
| 1700374725 | Renee Ahern | Registered Nurse | 398 Neponset Ave., Dorchester, MA 02122 | 2018-04-25 |
| 1861902371 | Bridget Mary Walsh | Specialist/Technologist | 519 Ashmont St, Dorchester, MA 02122 | 2017-10-10 |
| 1649798133 | Roosevelt Lewis IIi | Registered Nurse | 1486 Dorchester Ave Ste 206, Boston, MA 02122 | 2017-09-05 |
| 1811427404 | Hanh Nguyen | Counselor | 50 Redfield St, Suite 300, Dorchester, MA 02122 | 2017-06-15 |
| 1669902474 | Thuy T Nguyen | Counselor | 415 Neponset Avenue, Dorchester, MA 02122 | 2017-06-14 |
| 1093262651 | David Scot Rapaport | Counselor | 1452 Dorchester Avenue, Fcbl-4, Boston, MA 02122 | 2016-09-01 |
| 1891171021 | Shannon K Mullen | Registered Nurse | 20 Thelma Rd, Dorchester, MA 02122 | 2015-08-11 |
| Find all providers in zip 02122 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447636 | Sarah Wieman | Student in an Organized Health Care Education/Training Program | 16 Blossom St Fl 1, Boston, MA 02114-3104 | 2020-11-03 |
| 1932709938 | Brianna Mae Duval | Student in an Organized Health Care Education/Training Program | 58 Colborne Rd, Boston, MA 02135-4103 | 2020-10-28 |
| 1780281279 | Sarah Hamad Alsaggabi | Student in an Organized Health Care Education/Training Program | 55 Traveler St Apt 1310, Boston, MA 02118-2973 | 2020-10-07 |
| 1821695933 | Matthew John Needham | Student in an Organized Health Care Education/Training Program | 330 Brookline Ave, Yamins 2nd Floor, Department of Anesthesia, Boston, MA 02215 | 2020-10-02 |
| 1013524339 | Jacqueline Busa | Student in an Organized Health Care Education/Training Program | Northeastern University 336 Huntington Ave, Boston, MA 02115 | 2020-09-30 |
| 1558978957 | Tien-hsin Chang | Student in an Organized Health Care Education/Training Program | 1 Kneeland Street (tufts University School of Dental Me, Boston, MA 02111 | 2020-09-29 |
| 1417564279 | Katherine Rose Brainard | Student in an Organized Health Care Education/Training Program | 336 Huntington Avenue, Boston, MA 02115 | 2020-09-25 |
| 1962018069 | Cara Connors | Student in an Organized Health Care Education/Training Program | 18 Wiget St Apt 1, Boston, MA 02113-2363 | 2020-09-23 |
| 1023624608 | Bernadette Avila | Student in an Organized Health Care Education/Training Program | 19 Peterborough St Apt 5, Boston, MA 02215-4409 | 2020-09-19 |
| 1588276281 | Guoliang Qiao | Student in an Organized Health Care Education/Training Program | Massachusetts General Hospital, 55 Fruit Street., Boston, MA 02114 | 2020-08-24 |
| Find all providers in BOSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.