Provider Demographics
NPI:1336547165
Name:ISBELL, WANDA (APRN-BC)
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:
Last Name:ISBELL
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12120 SAVAGE DR
Mailing Address - Street 2:
Mailing Address - City:MIDWAY
Mailing Address - State:TX
Mailing Address - Zip Code:75852-3654
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12120 SAVAGE DR
Practice Address - Street 2:
Practice Address - City:MIDWAY
Practice Address - State:TX
Practice Address - Zip Code:75852-3654
Practice Address - Country:US
Practice Address - Phone:936-348-3751
Practice Address - Fax:936-348-3751
Is Sole Proprietor?:No
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX606715363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care