Provider Demographics
NPI:1376756387
Name:TRUSKOWSKI, TESSIE B (CRNP)
Entity Type:Individual
Prefix:
First Name:TESSIE
Middle Name:B
Last Name:TRUSKOWSKI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 HILLTOP CT
Mailing Address - Street 2:
Mailing Address - City:BADEN
Mailing Address - State:PA
Mailing Address - Zip Code:15005-2417
Mailing Address - Country:US
Mailing Address - Phone:724-869-5937
Mailing Address - Fax:
Practice Address - Street 1:401 1ST ST
Practice Address - Street 2:
Practice Address - City:FREEDOM
Practice Address - State:PA
Practice Address - Zip Code:15042-2464
Practice Address - Country:US
Practice Address - Phone:724-266-2833
Practice Address - Fax:724-869-5321
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP003905B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily