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NPI Code Detail

MEDICARE: LISA ISAKSEN NP-C, PMHNP-BC

MEDICARE: LISA ISAKSEN NP-C, PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerNP-1675AID
2363LF0000XFamily Nurse PractitionerNP-1675AID

General Provider Information

NPI Number : 1841655826
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA ISAKSEN NP-C, PMHNP-BC
Provider Business Mailing Address
First Line : 1202 E LOCUST ST
Second Line :
City : EMMETT
State : ID
Zip : 83617-2715
Country : US
Telephone Number : 208-365-3561
Fax Number :
Provider Business Practice Location Address
First Line : 1202 E LOCUST ST
Second Line :
City : EMMETT
State : ID
Zip : 83617-2715
Country : US
Telephone Number : 208-365-3561
Fax Number : 208-365-3589
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2015
Last Update Date : 02/20/2025

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