Individual
NICOLE SCHANTA RUSINOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A-GNP-C
Contact information
Practice address
41800 W 11 MILE RD STE 109, NOVI, MI 48375-1818
(586) 524-5968
Mailing address
1319 S WASHINGTON AVE, ROYAL OAK, MI 48067-3200
(586) 524-5968
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704321524
MI
Other
Enumeration date
10/10/2022
Last updated
04/05/2024
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