Provider Demographics
NPI:1629649322
Name:ISBRECHT, SARAH MAY (CPHT)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MAY
Last Name:ISBRECHT
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6535 PAW PAW AVE
Mailing Address - Street 2:
Mailing Address - City:COLOMA
Mailing Address - State:MI
Mailing Address - Zip Code:49038-8805
Mailing Address - Country:US
Mailing Address - Phone:269-468-3858
Mailing Address - Fax:269-468-4423
Practice Address - Street 1:6535 PAW PAW AVE
Practice Address - Street 2:
Practice Address - City:COLOMA
Practice Address - State:MI
Practice Address - Zip Code:49038-8805
Practice Address - Country:US
Practice Address - Phone:269-468-3858
Practice Address - Fax:269-468-4423
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-05
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5303034847183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1496968OtherNATIONAL BOARD OF PHARMACY