Individual
PHILLIP PRUSINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
4350 N 19TH AVE, #6, PHOENIX, AZ 85015-4602
(480) 607-1124
Mailing address
4350 N 19TH AVE, #6, PHOENIX, AZ 85015-4602
(480) 607-1124
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP9609
AZ
Other
Enumeration date
11/04/2016
Last updated
11/04/2016
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