Healthcare Provider Details

I. General information

NPI: 1326979428
Provider Name (Legal Business Name): LAUREN KULASZEWSKI CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 CLINTON ST
WYANDOTTE MI
48192-2660
US

IV. Provider business mailing address

707 CLINTON ST
WYANDOTTE MI
48192-2660
US

V. Phone/Fax

Practice location:
  • Phone: 734-363-9260
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4704374430
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704374430
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: