Healthcare Provider Details

I. General information

NPI: 1265050538
Provider Name (Legal Business Name): DIANA LYNN ISAACS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2020
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 N CANFIELD NILES RD
AUSTINTOWN OH
44515-2340
US

IV. Provider business mailing address

1630 GULLY TOP LN
CANFIELD OH
44406-8319
US

V. Phone/Fax

Practice location:
  • Phone: 330-915-7551
  • Fax: 330-330-8818
Mailing address:
  • Phone: 330-518-7772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0027085
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP.0027085
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: