Provider Demographics
NPI:1003281627
Name:ISENBERG, JAMES (APRN)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:ISENBERG
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 TRIGG CT
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-2252
Mailing Address - Country:US
Mailing Address - Phone:270-361-9285
Mailing Address - Fax:
Practice Address - Street 1:201 PROFESSIONAL PARK DR
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-3486
Practice Address - Country:US
Practice Address - Phone:270-392-3661
Practice Address - Fax:580-297-9310
Is Sole Proprietor?:No
Enumeration Date:2015-12-08
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3009903363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner