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General NPI Number Information
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NPI Number | 1669257267
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Entity Type | Individual
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Provider Name | ASMA ISACK
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Gender | Female
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Dates
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Enumeration Date | 08/30/2023
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Last Update Date | 06/08/2026
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Provider Practice Location Address
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Address Line | 4919 W EVA ST
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City | GLENDALE
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State | AZ
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Zip | 85302-3520
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Country | US
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Telephone | 951-329-7638
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Fax |
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Provider Business Mailing Address
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Address Line | 4919 W EVA ST
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City | GLENDALE
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State | AZ
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Zip | 85302-3520
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Country | US
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Telephone | 951-329-7638
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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 | 163WX0003X
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Taxonomy Name | Inpatient Obstetric Registered Nurse
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License Number | 265583
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | L-317144
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 265583
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License Number State | AZ
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