Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 100536 | CO |
NPI | 1033401278 |
---|---|
Provider Name | Adrienne Camille Isaacs |
First Address | Colorado Springs, CO 80909-5533 |
Second Address | Colorado Springs, CO 80909-5533 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2011 |
Last Update Date | 24/01/2013 |