Doctor Name: | MR. MARTIN ISENHART |
NPI Number: | 1639509078 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | RN |
License Number: | 4704268278 |
Business Practice Address: | 1049 E Newell St White Cloud, MI - 493498795 |
Business Phone Number: | 2316897330 |
Business Fax Number: | 2316897500 |
Mailing Address: | 5068 W 116th St, GRANT |
State: | MI |
Postal Code: | 493278918 |
Phone Number: | 2318345060 |
Fax Number: | 2316897500 |
NPI Enumeration Date: | 11/21/2013 |
NPI Last Update Date: | 11/21/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0808X |
License Number: | 4704268278 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |