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Individual

SUSANNA ELIZABETH PITRUZZELLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
6701 AIRPORT BLVD., B BLDG., T LEVEL, MOBILE, AL 36608-3764
(251) 625-6896
Mailing address
29653 ANCHOR CROSS BLVD, DAPHNE, AL 36526-9594
(251) 625-6896

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
1102256
AL
363LF0000X
Family Nurse Practitioner
Primary
1-102256
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
102I506543
MEDICARE PTAN
AL
05
130124
AL
05
212689
AL
01
P02453782
RAILROAD MEDICARE
AL
Enumeration date
02/04/2011
Last updated
02/23/2022
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