Individual provider · NPI-1

Stacy Marie Bissoon, CNP

Nurse Practitioner, Women's Health · Sioux Falls, SD

NPI number1760838098

StatusActive

Last updated in NPPESDec 17, 2024

Details

NPI: 1760838098
Entity type: Individual (NPI-1)
Name: Mrs. Stacy Marie Bissoon
Credential: CNP
Sex: Female
Sole proprietor: No
Enumeration date: May 5, 2016
Certification date: Dec 17, 2024
Last updated: Dec 17, 2024

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LW0102X	Nurse Practitioner, Women's Health	CP000927	SD	Yes
363LX0001X	Nurse Practitioner, Obstetrics & Gynecology	CP000927	SD

Practice location

5128 S Cliff Ave Ste 102
Sioux Falls, SD 57108-5454

Phone 605-206-3839

Mailing address

5128 S Cliff Ave Ste 102
Sioux Falls, SD 57108-5454

Phone 605-206-3839

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