Provider Demographics
NPI:1609549062
Name:DROGOWSKI, AMANDA FRANCES (CRNA)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:FRANCES
Last Name:DROGOWSKI
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 1:3571 BUCKINGHAM AVE
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MI
Mailing Address - Zip Code:48072-1462
Mailing Address - Country:US
Mailing Address - Phone:248-762-0038
Mailing Address - Fax:
Practice Address - Street 1:1523 VERNIER LANE
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48366-0021
Practice Address - Country:US
Practice Address - Phone:248-762-0038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-30
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704318302367500000X
MI47043183163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse