Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kristen Michele Prusa, AGACNP-BC

Individual provider Acute Care Nurse Practitioner · NPI 1477120582

Kristen Michele Prusa, AGACNP-BC is a Nurse Practitioner in Burbank, California. Qualified in 2020, 6 years ago. Practices with Mordo Suchov MD Inc, a 14-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
6
Licensed in
CA
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

191 S Buena Vista St Ste 215
Burbank, CA 91505-4563
Phone: (818) 906-4071
Fax: (818) 905-7406
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 95017466 (CA)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence 95017466 (CA)

Record details

NPI number1477120582
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP-BC
Sole proprietorNo
NPI enumeratedJune 7, 2021
Last updated in NPPESFebruary 23, 2022
Certification dateFebruary 23, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Mordo Suchov Md Inc — 14 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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