Individual
LISA ANN JURICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
36475 FIVE MILE RD, LIVONIA, MI 48154-1971
(734) 655-2031
Mailing address
PO BOX 67000, DEPT 203401, DETROIT, MI 48267-2034
(952) 442-9770
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704177116
MI
Other
Enumeration date
09/20/2006
Last updated
05/29/2020
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