Brust, Susan R

Brust, Susan R is an sole proprietor health care provider with primary practice located at 1100 Lake View Dr , Wausau WI 54403-6799. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Brust, Susan R can be contacted via phone (715) 848-4600.

Contact Information

Primary practice address
1100 Lake View Dr Wausau WI 54403-6799
Phone: (715) 848-4600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 8103 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X R1306952 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 8103-33 Wisconsin

Profile Details

NPI number 1952415085
LBN Legal business name Brust, Susan R
Credentials PSYCH NP, CNS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 18th, 2006
Last updated Mar 30th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952415085 NPPES
Minnesota Other 125674 MMSI
Minnesota Other 162P6BR MMSI
Minnesota MEDICAID 1351033600 MMSI
Minnesota Other 164P4SU MMSI
Minnesota Other 83-60115 MMSI

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