Individual
MRS. GRACE ISAACS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2944 BRECKENRIDGE LN, LOUISVILLE, KY 40220-1409
(502) 893-0159
Mailing address
2944 BRECKENRIDGE LN, LOUISVILLE, KY 40220-1409
(502) 893-0159
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2354
KY
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
PA2354
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K208110
MEDICARE
KY
Enumeration date
07/20/2016
Last updated
11/15/2022
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