Provider Demographics
NPI:1225441199
Name:ISCO, AMY JO (CNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JO
Last Name:ISCO
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:JO
Other - Last Name:GABRIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:638 BLARNEY STONE CT
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-9112
Mailing Address - Country:US
Mailing Address - Phone:614-370-2909
Mailing Address - Fax:
Practice Address - Street 1:3455 MILL RUN DR STE 310
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-9082
Practice Address - Country:US
Practice Address - Phone:833-358-2278
Practice Address - Fax:855-362-0779
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-08
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA16097NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily