Provider Demographics
NPI:1568929172
Name:ISLE, LORI DIANE (MSN, FNP, APRN-C)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:DIANE
Last Name:ISLE
Suffix:
Gender:F
Credentials:MSN, FNP, APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 PETER PAN RD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:KS
Mailing Address - Zip Code:67301-7301
Mailing Address - Country:US
Mailing Address - Phone:760-468-8371
Mailing Address - Fax:
Practice Address - Street 1:510 PETER PAN RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:KS
Practice Address - Zip Code:67301-7301
Practice Address - Country:US
Practice Address - Phone:760-468-8371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-01
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-78628-081363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily