IndividualActive
Alicia Prucknic, RN, BSN, CCM
NPI 1336814599 · Psychiatric/Mental Health Nurse Practitioner · Brownstown Twp, MI
Provider details
- NPI number
- 1336814599
- Entity type
- Individual
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- RN, BSN, CCM
- Sex
- Female
- Sole proprietor
- Yes
- License
- 4704244622 (MI)
Practice location
23772 West Rd # 262
Brownstown Twp, MI 48183-3050
Phone: (734) 788-9111
Fax: (734) 941-3264
Mailing address
23772 West Rd # 262
Brownstown Twp, MI 48183-3050
Registry dates
- Enumerated
- 2021-08-10
- Last updated
- 2025-02-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.