Provider Demographics
NPI:1639201395
Name:ENGELBRECHT, ASMA IQSBAL (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:ASMA
Middle Name:IQSBAL
Last Name:ENGELBRECHT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:ASMA
Other - Middle Name:IQSBAL
Other - Last Name:MEHBOOB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:12080 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-1882
Mailing Address - Country:US
Mailing Address - Phone:734-284-1874
Mailing Address - Fax:
Practice Address - Street 1:2333 BIDDLE AVE
Practice Address - Street 2:
Practice Address - City:WYANDOTTE
Practice Address - State:MI
Practice Address - Zip Code:48192-4668
Practice Address - Country:US
Practice Address - Phone:734-246-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704232226164W00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No164W00000XNursing Service ProvidersLicensed Practical Nurse