MEDICARE: ISABEL MARIE MCKINSEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1024771	TX

General Provider Information

NPI Number	:	1659262020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISABEL MARIE MCKINSEY

Provider Business Mailing Address
First Line	:	231 W SOUTHLAKE BLVD STE 160
Second Line	:
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-7037
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	231 W SOUTHLAKE BLVD STE 160
Second Line	:
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-7037
Country	:	US
Telephone Number	:	817-678-5388
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2025
Last Update Date	:	03/18/2026

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