Provider Demographics
NPI:1265050538
Name:ISAACS, DIANA LYNN (CNP)
Entity type:Individual
Prefix:MS
First Name:DIANA
Middle Name:LYNN
Last Name:ISAACS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 GULLY TOP LN
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-8319
Mailing Address - Country:US
Mailing Address - Phone:330-518-7772
Mailing Address - Fax:
Practice Address - Street 1:60 N CANFIELD NILES RD
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2340
Practice Address - Country:US
Practice Address - Phone:330-915-7551
Practice Address - Fax:330-330-8818
Is Sole Proprietor?:No
Enumeration Date:2020-07-13
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0027085363LP0808X
OHCNP.0027085363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily