DEBRA ANN RUSTAD (NPI# 1487659587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487659587 |
| Entity Type | Individual |
| Full Name | DEBRA ANN RUSTAD |
| Credential | RN, CNP |
| Practice Address |
3850 Park Nicollet Blvd Park Nicollet Clinic--senior Services-- 3rd Floor St Louis Park MN 55416-2527 |
| Mailing Address |
10512 Maryland Rd Bloomington MN 55438-2169 |
| Practice Telephone | 9529935041 |
| Practice Fax Number | 9529933236 |
| Mailing Telephone | 9528880287 |
| Mailing Fax Number | 9529410233 |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2012-04-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
R092748-4 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 090529100 | 05 |
| Street Address |
3850 PARK NICOLLET BLVD PARK NICOLLET CLINIC--SENIOR SERVICES-- 3RD FLOOR |
| City | ST LOUIS PARK |
| State | MN |
| Zip Code | 55416-2527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386280030 | Melissa Jean Neiert | Social Worker | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2019-11-18 |
| 1083261101 | Annemarie Rose Kettler | Dietitian, Registered | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2019-08-22 |
| 1427601772 | Michaela Rae Schleinz | Occupational Therapist | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2019-07-16 |
| 1720545627 | Rose Alicia Crider | Dietitian, Registered | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2019-02-27 |
| 1114435773 | Adam James Uithoven | Physician Assistant | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2018-01-17 |
| 1285140442 | Jessica Mae Brabender | Nurse Practitioner | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2017-12-22 |
| 1043729064 | Grace Marie Irish | Nurse Practitioner | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2017-09-21 |
| 1760908131 | Elin Christine Pool | Physician Assistant | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2017-08-17 |
| 1912422718 | Kathleen Therese Guinee Holman | Nurse Practitioner | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2017-08-14 |
| 1972025161 | Katie Wocken Louwagie | Nurse Practitioner | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2017-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639711492 | Ismahan Abdirahman Mohamed | Psychologist | 4236 Parkglen Rd, St Louis Park, MN 55416 | 2019-10-14 |
| 1598307860 | Ayman Abulaziz Mohamed | Counselor | 4326 Park Glen Rd, St Louis Park, MN 55416 | 2019-10-08 |
| 1831758929 | Ally Group Homes LLC | Assisted Living Facility | 2944 Princeton Ave South, Saint Louis Park, MN 55416 | 2019-06-11 |
| 1609371525 | Heather Margaret Flatgard | Chiropractor | 5407 Excelsior Blvd Ste D, St Louis Park, MN 55416 | 2018-03-25 |
| 1942702394 | Polaris Pharmacy Services of Minnesota, LLC | Pharmacy | 4220 Park Glen Road, St. Louis Park, MN 55416 | 2018-03-01 |
| 1316469760 | Evert Ray Boyd | Psychologist | 3200 Highway 100 S., Groves Academy, St Louis Park, MN 55416 | 2017-07-07 |
| 1861941684 | Amanda Marie Tapper | Marriage & Family Therapist | 5407 Excelsior Blvd, Suite B, St Louis Park, MN 55416 | 2016-09-22 |
| 1326410416 | Clear Health Chiropractic LLC | Chiropractor | 5614 W 36th St, St. Louis Park, MN 55416 | 2015-10-28 |
| 1568897833 | Kay Elizabeth Lichtenberger | Physical Therapist | 4415 W 36.5 St, St. Louis Park, MN 55416 | 2013-09-05 |
| 1710221510 | Aaron Christopher Oppelt | Counselor | 1665 Utica Ave South - Suite 100, Saint Louis Park, MN 55416 | 2012-11-16 |
| Find all providers in zip 55416 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942664024 | Emily Samborn | Nurse Practitioner | 5525 Cedar Lake Rd S, St Louis Park, MN 55416-1420 | 2016-04-05 |
| 1962818021 | Sara Gauquie | Nurse Practitioner | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2014-07-09 |
| 1801176078 | Marijane Schroeder Hauer | Nurse Practitioner | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2011-08-19 |
| 1568777274 | Elizabeth Abell | Nurse Practitioner | 3931 Louisiana Ave S, St Louis Park, MN 55426 | 2010-08-18 |
| 1730342072 | Nicole M Larson | Nurse Practitioner | 3931 Louisiana Ave S, St Louis Park, MN 55426-5000 | 2008-07-08 |
| 1932275880 | Jody Lynn Juntunen | Nurse Practitioner | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2006-11-24 |
| 1285611772 | Christa G Beach | Nurse Practitioner | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2005-12-27 |
| 1952388779 | Sherry Wenisch | Nurse Practitioner | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2005-12-22 |
| 1346226099 | Pamela J Garrison | Nurse Practitioner | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2005-12-15 |
| 1699750141 | Diane P Dunn | Nurse Practitioner | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2005-12-07 |
| Find all providers in ST LOUIS PARK | ||||
| City | ST LOUIS PARK |
| Zip Code | 55416 |
Please comment or provide details below to improve the information on DEBRA ANN RUSTAD.
| 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.