Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 116 | OK |
N | 222Z00000X | Podiatrist | 116 | OK |
Y | 213E00000X | Podiatrist | 1893 | TX |
Y | 222Z00000X | Podiatrist | 1893 | TX |
N | 224P00000X | Prosthetist | 116 | OK |
NPI | 1235643933 |
---|---|
Provider Name | Elizabeth Joan Isensee |
First Address | Norman, OK 73072-2483 |
Second Address | Norman, OK 73072-2483 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2017 |
Last Update Date | 25/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
116 | OKLAHOMA BOARD OF MEDICAL LICENSURE AND SUPERVISION (01) | OK |
1893 | TEXAS DEPARTMENT OF LICENSING AND REGULATION (01) | TX |