Individual
MICHELLE LUSTRE NOSAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1447 N HARRISON ST, SAGINAW, MI 48602-4727
(989) 583-6237
(989) 583-6032
Mailing address
285 ANGOLA ST, WOLVERINE LAKE, MI 48390-2113
(248) 767-7871
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704149936
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104299871
—
MI
01
—
ML149936
BLUE CROSS OF MI
MI
Enumeration date
01/17/2006
Last updated
06/10/2014
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