MEDICARE: MS. LINDA JOI ISENBERG

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1104452879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA JOI ISENBERG

Provider Business Mailing Address
First Line	:	3671 SHEFFIELD MONROE RD
Second Line	:
City	:	KINGSVILLE
State	:	OH
Zip	:	44048-7720
Country	:	US
Telephone Number	:	440-265-5719
Fax Number	:

Provider Business Practice Location Address
First Line	:	5927 JEFFERSON AVE APT 10
Second Line	:
City	:	ASHTABULA
State	:	OH
Zip	:	44004-7568
Country	:	US
Telephone Number	:	440-228-1548
Fax Number	:

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

Provider Enumeration Date	:	03/13/2020
Last Update Date	:	03/13/2020

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