Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | CP001117 | SD |
NPI | 1003361296 |
---|---|
Provider Name | Kaitlyn Sarah Isaacson |
First Address | Sioux Falls, SD 57108-2571 |
Second Address | Sioux Falls, SD 57108-2571 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2016 |
Last Update Date | 17/08/2016 |