Healthcare Provider Details

I. General information

NPI: 1215358411
Provider Name (Legal Business Name): NICOLE ELIZABETH ISAAC APRN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2013
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10151 DEERWOOD PARK BLVD # 300
JACKSONVILLE FL
32256-0566
US

IV. Provider business mailing address

1945 LAKEPOINTE DR
LEWISVILLE TX
75057-6469
US

V. Phone/Fax

Practice location:
  • Phone: 800-835-2362
  • Fax:
Mailing address:
  • Phone: 800-835-2362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3008383
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: