Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Tracy Bosanko, PMHNP

Individual provider Adult Psychiatric/Mental Health Registered Nurse · NPI 1184445264

Tracy Bosanko, PMHNP is a Nurse Practitioner in Livonia, Michigan. Qualified in 2024, 2 years ago. Practices with Victor M. Cruz MD, PC, a 29-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
2
Licensed in
MI
In the registry since
2024
What do these letters mean?
PMHNP — Psychiatric-Mental Health Nurse Practitioner
A nurse practitioner specialising in mental health, able to prescribe psychiatric medication.

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Practice location Address checks out

17177 N Laurel Park Dr Ste 131
Livonia, MI 48152-3952
Phone: (734) 462-3210
Fax: (734) 462-1024
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5842 Hathaway Rd, Canton, MI 48187-5609 — (734) 536-3043

Specialties & licences

Adult Psychiatric/Mental Health Registered Nurse (primary) Taxonomy 163WP0809X · Licence 4704329968 (MI)

Record details

NPI number1184445264
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP
Sole proprietorYes
NPI enumeratedOctober 21, 2024
Last updated in NPPESJune 6, 2025
Certification dateJune 6, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Victor M. Cruz Md, P.C. — 29 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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