Individual
JO ANN MARIE PUPALOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
901 MACARTHUR BLVD, ATTN ANESTHESIA, MUNSTER, IN 46321-2901
(219) 836-7040
(219) 513-1127
Mailing address
901 MACARTHUR BLVD, ATTN ANESTHESIA, MUNSTER, IN 46321-2901
(219) 836-7040
(219) 513-1127
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28171629A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000634222
—
IN
01
—
P00803962
MEDICARE RAILROAD
IN
Enumeration date
09/22/2009
Last updated
05/14/2010
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