Rusk, Suzanne S

Rusk, Suzanne S is an individual health care provider with primary practice located at 5200 Fairview Boulevard Fairview Lakes Pediatrics, Wyoming MN 55092. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Rusk, Suzanne S can be contacted via phone (651) 682-7340.

Contact Information

Primary practice address
5200 Fairview Boulevard Fairview Lakes Pediatrics Wyoming MN 55092
Fax: (651) 982-7349
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X R-111703-1 Minnesota

Profile Details

NPI number 1528152915
LBN Legal business name Rusk, Suzanne S
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Dec 26th, 2014 - about 11 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 1528152915 NPPES
New Mexico MEDICAID 42088721

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