Individual
KAYONNA BRUZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
968 BUCKLEY RD, MONTROSE, PA 18801-7868
(570) 396-8317
Mailing address
968 BUCKLEY RD, MONTROSE, PA 18801-7868
(570) 396-8317
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
33711701
NY
Other
Enumeration date
12/04/2019
Last updated
12/04/2019
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