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General NPI Number Information
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NPI Number | 1104914746
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Entity Type | Individual
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Provider Name | LUCIE BRANDSTETROVA ENGELSKIRGER CNP
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Gender | Female
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 04/17/2017
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Provider Practice Location Address
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Address Line | 11100 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44106-1716
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Country | US
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Telephone | 216-844-1015
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Fax | 216-844-1202
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Provider Business Mailing Address
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Address Line | 92 WEST RIVER RD.
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City | VALLEY CITY
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State | OH
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Zip | 44280
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Country | US
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Telephone | 216-233-3080
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | NP-08062
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License Number State | OH
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