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Individual

KRISTEN MICHELE PRUSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGACNP-BC

Contact information

Practice address
191 S BUENA VISTA ST STE 215, BURBANK, CA 91505-4563
(818) 906-4071
(818) 905-7406
Mailing address
16260 VENTURA BLVD STE LL15, ENCINO, CA 91436-4931
(818) 905-1567
(818) 905-7406

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95017466
CA
363LA2100X
Acute Care Nurse Practitioner
95017466
CA

Other

Enumeration date
06/07/2021
Last updated
02/23/2022
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