Healthcare Provider Details

I. General information

NPI: 1003770314
Provider Name (Legal Business Name): LAWANDA ISAAC RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 PENFIELD AVE
AKRON OH
44310-2912
US

IV. Provider business mailing address

56 OLALLA AVE
TALLMADGE OH
44278-2724
US

V. Phone/Fax

Practice location:
  • Phone: 330-762-6110
  • Fax: 330-253-6810
Mailing address:
  • Phone: 330-762-6110
  • Fax: 330-253-6810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number447594
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: