Provider Demographics
NPI:1285895037
Name:ISAKSEN, ANN LISA (MD)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:LISA
Last Name:ISAKSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 PARK AVE
Mailing Address - Street 2:DEPT OF MEDICINE, MEDICINE DIVISION
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1829
Mailing Address - Country:US
Mailing Address - Phone:612-873-4455
Mailing Address - Fax:612-904-5427
Practice Address - Street 1:701 PARK AVE
Practice Address - Street 2:DEPT OF MEDICINE, MEDICINE DIVISION
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1829
Practice Address - Country:US
Practice Address - Phone:612-873-4455
Practice Address - Fax:612-904-5427
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN105729207R00000X
MN54698208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine