Individual
NICOLE MARIE PETRUNGARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
901 MACARTHUR BLVD, MUNSTER, IN 46321-2901
(219) 836-1600
Mailing address
901 MACARTHUR BLVD., MUNSTER, IN 46321
(219) 836-1600
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28226848A
IN
Other
Enumeration date
02/03/2016
Last updated
02/03/2016
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