Provider Demographics
NPI:1427656735
Name:JAMES, KISHA LANECE (MSN, FNP-BC)
Entity type:Individual
Prefix:MS
First Name:KISHA
Middle Name:LANECE
Last Name:JAMES
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 RED MULBERRY WAY APT 3
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25306-0107
Mailing Address - Country:US
Mailing Address - Phone:304-989-8534
Mailing Address - Fax:
Practice Address - Street 1:16 RED MULBERRY WAY APT 3
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25306-0107
Practice Address - Country:US
Practice Address - Phone:304-989-8534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV107514363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily