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NPI Code Detail

MEDICARE: MICHELLE P ISACSON APRN

MEDICARE: MICHELLE P ISACSON 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
1363L00000XNurse Practitioner7718-33WI
2363LF0000XFamily Nurse Practitioner7718-33WI
3363L00000XNurse Practitioner71014439AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760432157
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE P ISACSON APRN
Provider Business Mailing Address
First Line : 14355 MIRANDA WAY
Second Line :
City : LOS ALTOS HILLS
State : CA
Zip : 94022-2032
Country : US
Telephone Number : 888-731-8994
Fax Number : 888-732-8119
Provider Business Practice Location Address
First Line : 111 W JACKSON BLVD STE 1700
Second Line :
City : CHICAGO
State : IL
Zip : 60604-3597
Country : US
Telephone Number : 888-731-8994
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2006
Last Update Date : 03/15/2024

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