Individual
MRS. SAMANTHA ROSE PETROVSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6071 W OUTER DR, DETROIT, MI 48235-2624
(313) 966-3300
Mailing address
24711 BROOKSHIRE DR, MACOMB, MI 48042-4745
(586) 722-8251
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704294114
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704294114
MI
Other
Enumeration date
07/18/2018
Last updated
12/19/2023
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