| Doctor Name: | STEPHANIE A PERUSKI |
| NPI Number: | 1003285024 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 4704282943 |
| Business Practice Address: | 251 E Peck Rd Peck, MI - 484669589 |
| Business Phone Number: | 8103784900 |
| Business Fax Number: | 8103784905 |
| Mailing Address: | 120 N Delaware St, SANDUSKY |
| State: | MI |
| Postal Code: | 484711009 |
| Phone Number: | 8106480561 |
| Fax Number: | 8106483352 |
| NPI Enumeration Date: | 09/21/2015 |
| NPI Last Update Date: | 09/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 4704282943 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |