Provider Demographics
NPI:1134115892
Name:AMANN, ISABELLE T (DNP)
Entity Type:Individual
Prefix:
First Name:ISABELLE
Middle Name:T
Last Name:AMANN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 FALL HILL AVE
Mailing Address - Street 2:SUITE 234
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3342
Mailing Address - Country:US
Mailing Address - Phone:540-741-2045
Mailing Address - Fax:540-741-3562
Practice Address - Street 1:2300 FALL HILL AVE
Practice Address - Street 2:SUITE 234
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3342
Practice Address - Country:US
Practice Address - Phone:540-741-2045
Practice Address - Fax:540-741-3562
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024164409363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P21652Medicare UPIN
VA017364F66Medicare PIN