Individual
VICKI A LYSKAWA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
22401 FOSTER WINTER DR, SOUTHFIELD, MI 48075-3724
(248) 423-5100
Mailing address
22713 SHADOWGLEN DR, FARMINGTON HILLS, MI 48335-3655
(248) 474-5504
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704108257
MI
Other
Enumeration date
05/08/2006
Last updated
07/08/2007
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