Provider Demographics
NPI:1104914746
Name:ENGELSKIRGER, LUCIE BRANDSTETROVA (CNP)
Entity type:Individual
Prefix:MRS
First Name:LUCIE
Middle Name:BRANDSTETROVA
Last Name:ENGELSKIRGER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 WEST RIVER RD.
Mailing Address - Street 2:
Mailing Address - City:VALLEY CITY
Mailing Address - State:OH
Mailing Address - Zip Code:44280
Mailing Address - Country:US
Mailing Address - Phone:216-233-3080
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-1015
Practice Address - Fax:216-844-1202
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-08062363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health