Provider Demographics
NPI:1699592220
Name:NATASHA L ISAMAN MSN, PMHNP-BC, APRN
Entity type:Organization
Organization Name:NATASHA L ISAMAN MSN, PMHNP-BC, APRN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:218-205-2608
Mailing Address - Street 1:15976 COUNTY HIGHWAY 6
Mailing Address - Street 2:
Mailing Address - City:LAKE PARK
Mailing Address - State:MN
Mailing Address - Zip Code:56554-9111
Mailing Address - Country:US
Mailing Address - Phone:218-205-2608
Mailing Address - Fax:
Practice Address - Street 1:15976 COUNTY HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:MN
Practice Address - Zip Code:56554-9111
Practice Address - Country:US
Practice Address - Phone:218-420-0202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-24
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Multi-Specialty