| NPI | 1164586624 |
|---|---|
| Former Name | AMY JO KUST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 4178-33) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: WI 114406-030) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704344454) | |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2021-01-13 |