MEDICARE: SUSANNA ELIZABETH PITRUZZELLO CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	1102256	AL
2	363LF0000X	Family Nurse Practitioner	1-102256	AL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P02453782	OTHER	AL	RAILROAD MEDICARE
4	102I506543	OTHER	AL	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811293087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSANNA ELIZABETH PITRUZZELLO CRNP

Provider Business Mailing Address
First Line	:	29653 ANCHOR CROSS BLVD
Second Line	:
City	:	DAPHNE
State	:	AL
Zip	:	36526-9594
Country	:	US
Telephone Number	:	251-625-6896
Fax Number	:

Provider Business Practice Location Address
First Line	:	6701 AIRPORT BLVD.
Second Line	:	B BLDG., T LEVEL
City	:	MOBILE
State	:	AL
Zip	:	36608-3764
Country	:	US
Telephone Number	:	251-625-6896
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2011
Last Update Date	:	05/18/2026

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Directions to “ SUSANNA ELIZABETH PITRUZZELLO CRNP” Practice Location

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