Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 1030785 | TX |
NPI | 1023602778 |
---|---|
Provider Name | Stephanie Marie Isbell |
First Address | Dallas, TX 75284-4658 |
Second Address | Temple, TX 76502-5632 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2021 |
Last Update Date | 01/07/2021 |