JUSTIN ROBERT CUSICK (NPI# 1043561004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043561004 |
| Entity Type | Individual |
| Full Name | JUSTIN ROBERT CUSICK |
| Credential | CRNA |
| Practice Address |
8990 Springbrook Dr Nw Ste 250 Coon Rapids MN 55433-5884 |
| Mailing Address |
3514 Cherry Ln Unit A Woodbury MN 55129-8794 |
| Practice Telephone | 7633981176 |
| Mailing Telephone | 6513351665 |
| Enumeration Date | 2012-09-30 |
| Last Update Date | 2012-09-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163W00000X | Registered Nurse | R160593-8 | MN | Nursing Service Providers |
| N | 367500000X | Nurse Anesthetist, Certified Registered | 091716 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
8990 SPRINGBROOK DR NW STE 250 |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-5884 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790073153 | Summer Ann Burlingame | Nurse Anesthetist, Certified Registered | 8990 Springbrook Dr Nw Ste 250, Coon Rapids, MN 55433-5884 | 2011-07-19 |
| 1598158784 | Lisa Niemczyk Glogowski | Nurse Anesthetist, Certified Registered | 8990 Springbrook Dr Nw Ste 250, Coon Rapids, MN 55433 | 2015-03-11 |
| 1215377445 | Cecilia Margaret Manaois Sung | Registered Nurse | 8990 Springbrook Dr Nw Ste 250, Coon Rapids, MN 55433-5884 | 2013-07-02 |
| 1649539743 | Angela Suzanne Bothwell | Nurse Anesthetist, Certified Registered | 8990 Springbrook Dr Nw Ste 250, Coon Rapids, MN 55433-5884 | 2012-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| Taxonomy Code | 163W00000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.’s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span. |
| Notes: Sources: (2) American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215342357 | Barbara Hallblade | Registered Nurse | 11030 Mississippi Blvd Nw, Ste 328, Coon Rapids, MN 55433-3972 | 2014-06-27 |
| 1811287444 | Jonathan A Wymer | Registered Nurse | 101 Egret Blvd Nw, Coon Rapids, MN 55448-5077 | 2011-04-16 |
| 1124325196 | Nancy Lynne Rick | Registered Nurse | 11800 Eldorado St Nw, Apt. 302, Coon Rapids, MN 55433-2401 | 2011-02-27 |
| 1497773329 | Kitty C. Skoog | Registered Nurse | 4040 Coon Rapids Blvd Nw # 100, Coon Rapids, MN 55433-2522 | 2006-07-18 |
| 1730719113 | Molly Elizabeth Phillips | Registered Nurse | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 | 2020-01-24 |
| 1447749775 | Anne Rodekuhr | Registered Nurse | 11850 Blackfoot St Nw Ste 100, Coon Rapids, MN 55433 | 2018-05-02 |
| 1710401930 | Tehut T Tefera | Registered Nurse | 1930 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-4708 | 2017-07-30 |
| 1801346374 | Ana Burge | Registered Nurse | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 | 2016-10-09 |
| 1902254899 | Kelsey Lessard | Registered Nurse | 1323 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-5307 | 2016-06-01 |
| 1346631280 | Angela Kathleen Smaciarz | Registered Nurse | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2015-02-13 |
| Find all providers in COON RAPIDS | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.