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Individual

MRS. JESSICA LISA BRUSKOSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
600 GRANT ST, GARY, IN 46402-9985
(219) 886-4405
(219) 881-8801
Mailing address
13423 ARIZONA ST, CROWN POINT, IN 46307-9246
(219) 718-9056

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001374A
IN
363AM0700X
Medical Physician Assistant

Other

Enumeration date
10/25/2011
Last updated
08/05/2019
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