Provider Demographics
NPI:1740215912
Name:HRUSCHKA, CAROLYN CRANE (ANP)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:CRANE
Last Name:HRUSCHKA
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SAN FRANCISCO CRITICAL CARE MED GRP
Mailing Address - Street 2:2351 CLAY ST, SUITE 501
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-9411
Mailing Address - Country:US
Mailing Address - Phone:415-923-3421
Mailing Address - Fax:415-600-1414
Practice Address - Street 1:585 W COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-5000
Practice Address - Country:US
Practice Address - Phone:707-526-3500
Practice Address - Fax:707-526-2358
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15824363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health