Individual
TISHA PRUSAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA MS
Contact information
Practice address
5301 E HURON RIVER DR, DEPT OF ANESTHESIOLOGY, YPSILANTI, MI 48197-1051
(734) 712-3840
(734) 712-5526
Mailing address
5301 E. HURON RIVER DRIVE, DEPT OF ANESTHESIOLOGY, ANN ARBOR, MI 48106
(734) 712-3840
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704207329
MI
Other
Enumeration date
03/28/2006
Last updated
04/23/2008
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