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Individual

HEIDI L ANDRUSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1451 44TH AVE S, GRAND FORKS, ND 58201-3434
(701) 780-1700
Mailing address
6615 LAKE DR, GRAND FORKS, ND 58201-8321
(701) 746-7441
(701) 746-7447

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R27377
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
13129
ND
01
24572
BCBS
ND
01
365M4ST
BCBS
MN
05
368665500
MN
01
P00440923
RR MEDICARE
Enumeration date
10/05/2006
Last updated
04/02/2012
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