Basic Information
| Provider Information | |||||||||
| NPI: | 1477872513 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ISBELL | ||||||||
| FirstName: | FELICIA | ||||||||
| MiddleName: | DAWN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2315 DOUGHERTY FERRY ROAD, SUITE 211 | ||||||||
| Address2: | DES PERES MEDICAL ARTS PAVILLON II DEPT. INTERNAL MEDIC | ||||||||
| City: | ST. LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 63122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3149779600 | ||||||||
| FaxNumber: | 3149777922 | ||||||||
| Practice Location | |||||||||
| Address1: | 2315 DOUGHERTY FERRY ROAD, SUITE 211 | ||||||||
| Address2: | DES PERES MEDICAL ARTS PAVILLON II DEPT. INTERNAL MEDIC | ||||||||
| City: | ST. LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 63122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3149779600 | ||||||||
| FaxNumber: | 3149777922 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2010 | ||||||||
| LastUpdateDate: | 06/11/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 2009037133 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LA2200X | 209008476 | IL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.