Provider Demographics
NPI:1518204544
Name:DRUSAK, AMANDA LYNN (CRNA)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYNN
Last Name:DRUSAK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 REDSTONE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:PERRYOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15473-1286
Mailing Address - Country:US
Mailing Address - Phone:724-322-0581
Mailing Address - Fax:
Practice Address - Street 1:550 REDSTONE CHURCH RD
Practice Address - Street 2:
Practice Address - City:PERRYOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15473-1286
Practice Address - Country:US
Practice Address - Phone:724-322-0581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN583986367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered