Basic Information
| Provider Information | |||||||||
| NPI: | 1437510757 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SELL | ||||||||
| FirstName: | ANISSA | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1190 41ST DR | ||||||||
| Address2: | |||||||||
| City: | CHANUTE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 667207401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6204331806 | ||||||||
| FaxNumber: | 6203657717 | ||||||||
| Practice Location | |||||||||
| Address1: | 3066 N KENTUCKY ST | ||||||||
| Address2: | |||||||||
| City: | IOLA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 66749 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6203651185 | ||||||||
| FaxNumber: | 6203651038 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2016 | ||||||||
| LastUpdateDate: | 12/26/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 77175 | KS | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 364SF0001X | F0316302 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Family Health |
No ID Information.