Individual
JILLIAN JOYCE LUSARDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 577-3520
Mailing address
750 STEPHENSON HWY, BEAUMONT PAYOR CONTRACT SERVICES, TROY, MI 48083-1103
(248) 577-3520
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704263498
MI
Other
Enumeration date
08/28/2012
Last updated
02/01/2013
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