Provider Demographics
NPI:1821637349
Name:OSIEMO, ISABELLA (CRNP)
Entity Type:Individual
Prefix:
First Name:ISABELLA
Middle Name:
Last Name:OSIEMO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 RACE RD STE 403
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-2386
Mailing Address - Country:US
Mailing Address - Phone:480-878-7806
Mailing Address - Fax:443-732-0054
Practice Address - Street 1:1232 RACE RD STE 403
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-2386
Practice Address - Country:US
Practice Address - Phone:480-878-7806
Practice Address - Fax:443-732-0054
Is Sole Proprietor?:No
Enumeration Date:2020-01-01
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR202111363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology