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NPI 1417796608ActiveOrganization· Nurse Practitioner· Pikeville, KY
Nurse Practitioner in Pikeville, Kentucky, registered in NPPES in May 2024. The authorized official on file is Anna Sisco, CADC, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1417796608 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 20, 2024 |
| Last updated in NPPES | May 20, 2024 |
| Certified by provider | May 20, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | — | — |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (KY) |
|---|
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