{
"Npi": {
"NPI": "1144525957",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ISENBERG",
"FirstName": "LISA",
"MiddleName": null,
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "MSN PNP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1 MERCADO ST",
"SecondLineMailingAddress": "SUITE 160",
"MailingAddressCityName": "DURANGO",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "81301-7306",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "970-385-9850",
"MailingAddressFaxNumber": "970-385-9854",
"FirstLinePracticeLocationAddress": "231 S CLOVER DR STE 5",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BAYFIELD",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "81122-8833",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "970-403-4425",
"PracticeLocationAddressFaxNumber": "763-402-7597",
"EnumerationDate": "01/26/2011",
"LastUpdateDate": "08/04/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "2010041911",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LP0200X",
"TaxonomyName": "Pediatric Nurse Practitioner",
"LicenseNumber": "2010041911",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LP0200X",
"TaxonomyName": "Pediatric Nurse Practitioner",
"LicenseNumber": "APN.0991704-NP",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LP0200X",
"TaxonomyName": "Pediatric Nurse Practitioner",
"LicenseNumber": "C-APN.0000024-C-NP",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": "APN.0991704NP",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}