MS. MALLORY LYNN GUSTIN (NPI# 1437542016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437542016 |
| Entity Type | Individual |
| Full Name | MS. MALLORY LYNN GUSTIN |
| Credential | APRN, CNP |
| Practice Address |
1001 Hart Blvd Ste 100 Monticello MN 55362-8929 |
| Mailing Address |
1700 Highway 25 N Buffalo MN 55313-1930 |
| Practice Telephone | 7632952921 |
| Practice Fax Number | 7632713807 |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2016-03-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
CNP 3741 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
CNP 3741 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215411772 | Mallory Grace Gustin | Behavior Technician | 1100 Haxton Dr Unit 115, Fort Collins, CO 80525-6213 | 2018-09-20 |
| Street Address |
1001 HART BLVD STE 100 |
| City | MONTICELLO |
| State | MN |
| Zip Code | 55362-8929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316940109 | Devanshu V. Kansara | Specialist | 1001 Hart Blvd Ste 100, Monticello Clinic, Monticello, MN 55362-8929 | 2005-05-24 |
| 1851934848 | Maura Romanshek | Family Medicine | 1001 Hart Blvd Ste 100, Monticello, MN 55362-8929 | 2019-10-22 |
| 1013499367 | Kathryn Ann Alvarez | Physician Assistant | 1001 Hart Blvd Ste 100, Monticello, MN 55362-8929 | 2018-09-04 |
| 1538514658 | Heidi Renae Nichol | Family Medicine | 1001 Hart Blvd Ste 100, Monticello, MN 55362-8929 | 2016-04-26 |
| 1801202932 | Lynn Lampi | Nurse Practitioner | 1001 Hart Blvd Ste 100, Monticello, MN 55362-8929 | 2014-07-09 |
| 1477995272 | Kasy Lynn Omann | Nurse Practitioner | 1001 Hart Blvd Ste 100, Monticello, MN 55362-8929 | 2013-07-22 |
| 1528359452 | Abby R Labounty | Family Medicine | 1001 Hart Blvd Ste 100, Monticello, MN 55362-8929 | 2011-04-26 |
| 1952691313 | Bryan Mccoy Moritz | Physician Assistant | 1001 Hart Blvd Ste 100, Monticello, MN 55362 | 2011-04-19 |
| 1013103050 | Stellis Health, Pa | Clinic/Center | 1001 Hart Blvd Ste 100, Monticello, MN 55362-8929 | 2007-09-24 |
| 1487656344 | Mark D Nelson | Podiatrist | 1001 Hart Blvd Ste 100, Monticello, MN 55362-8929 | 2005-08-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275034886 | Great River Endodontics | Dentist | 9381 Cedar St., Monticello, MN 55362 | 2018-02-28 |
| 1467994962 | Jessica Borgstrom | Advanced Practice Midwife | 1001 Hart Blvd #100, Monticello, MN 55362 | 2016-11-15 |
| 1972922078 | Ashby Optometry PC | Optometrist | 1447 East 7th Street, Monticello, MN 55362 | 2014-04-16 |
| 1740612621 | Sarah Rowe | Physical Therapist | 1260 Mn-25, Monticello, MN 55362 | 2013-08-02 |
| 1144573775 | Kelley M Mcgowan | Physical Therapist | 211 Hwy 25, Monticello, MN 55362 | 2012-10-19 |
| 1275801581 | Roger William Hedtke | Pharmacist | 135 East Broadway, Monticello, MN 55362 | 2011-12-01 |
| 1811299019 | Pamela Marie Bertram | Social Worker | 228 W Broadway St, Monticello, MN 55362 | 2010-11-22 |
| 1265768220 | Back 2 Health Chiropractic, P.a. | Chiropractor | 1125 South Cedar St, Suite 109, Monticello, MN 55362 | 2009-10-27 |
| 1538328059 | Lakeland Family Dental | Dentist | 106 Broadway Street East, Monticello, MN 55362 | 2008-06-09 |
| 1205038163 | Buffalo Dental Center | Dentist | 106 1 In A Half W Broadway, Monticello, MN 55362 | 2007-06-04 |
| Find all providers in zip 55362 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245236603 | Sharon D Musall | Nurse Practitioner | 826 N 6th St, Monticello, IN 47960-1752 | 2005-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639731821 | Thomas Bieniek | Nurse Practitioner | 1900 Centracare Cir Ste 1600, Saint Cloud, MN 56303-5000 | 2019-07-08 |
| 1649830225 | Kimberly Dawn Hanson | Nurse Practitioner | 1884 Randolph Ave, Saint Paul, MN 55105-1747 | 2019-06-17 |
| 1942762828 | Jodi Lynn Martin | Nurse Practitioner | 720 Washington Ave Se Ste 300, Minneapolis, MN 55414-2904 | 2019-04-01 |
| 1831661123 | Sheryl Jo Rudolf | Nurse Practitioner | 705 Pleasant Avenue, Park Rapids, MN 56470-1440 | 2018-12-26 |
| 1043730310 | Alexis Oluwasheun Bakare | Nurse Practitioner | 1101 Paul Pkwy Ne Apt 215, Blaine, MN 55434-3977 | 2017-06-27 |
| 1528500360 | Judy Pauletich | Nurse Practitioner | 1255 Mayhill Rd N, Maplewood, MN 55119-7158 | 2016-11-10 |
| 1437506417 | Zahra Roble | Nurse Practitioner | 1801 Nicolllet Ave S, Minneapolis, MN 55403 | 2016-05-19 |
| 1932569035 | David Makonde Ogato | Nurse Practitioner | 5325 W 74th St, Edina, MN 55439-2231 | 2016-03-02 |
| 1164896379 | Brooke Johnson | Nurse Practitioner | 12700 Whitewater Dr, Minnetonka, MN 55343-9438 | 2015-11-25 |
| 1962879916 | Carrie Rose Lucio | Nurse Practitioner | 807 Albert St N, Saint Paul, MN 55104-1302 | 2015-08-25 |
| Find all providers with the same taxonomy | ||||
| City | MONTICELLO |
| Zip Code | 55362 |
Please comment or provide details below to improve the information on MS. MALLORY LYNN GUSTIN.
| 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.