Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TREY A KISSACK
Active Sole ProprietorTREY A KISSACK is a Community/Behavioral Health healthcare provider located in GRAND ISLAND, Nebraska. NPI 1417617911 is currently active in the NPPES registry. Verify at CMS.
Community/Behavioral Health · GRAND ISLAND, NE
Registration Details
- NPI Number
- 1417617911
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 23, 2021 (4.6210863418177 yrs)
- Last Updated
- Dec 23, 2021
- Sole Proprietor
- Yes
Practice Information
- Address
-
1811 W. 2ND STREET,SUITE 450GRAND ISLAND, NE, 688035473Browse NE providers · Browse ZIP 68803
- Phone
- 3083798619
- Fax
- 3086752690
- Primary Specialty
-
Community/Behavioral Health
251S00000X
Other Community/Behavioral Health Providers in GRAND ISLAND, NE
| Name | Credential | NPI |
|---|---|---|
| RICHARD LEE KISSACK | — | 1639839137 |
| STEPHANIE DETAMORE | — | 1295489557 |
| ALISHA N THOMPSON | MSW | 1013748326 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.