MEDICARE: NATASHA L ISAMAN MSN, PMHNP-BC, APRN

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1699592220
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATASHA L ISAMAN MSN, PMHNP-BC, APRN

Provider Business Mailing Address
First Line	:	15976 COUNTY HIGHWAY 6
Second Line	:
City	:	LAKE PARK
State	:	MN
Zip	:	56554-9111
Country	:	US
Telephone Number	:	218-420-0202
Fax Number	:	218-270-5134

Provider Business Practice Location Address
First Line	:	15976 COUNTY HIGHWAY 6
Second Line	:
City	:	LAKE PARK
State	:	MN
Zip	:	56554-9111
Country	:	US
Telephone Number	:	218-420-0202
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CLINICIAN
Name	:	NATASHA LYNN ISAMAN
Credential	:	PMHNP-BC
Telephone Number	:	218-420-0202

Provider Enumeration Date	:	09/24/2024
Last Update Date	:	10/27/2025

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