| NPI | 1851881213 |
|---|---|
| Former Name | TAYLOR J RUSTAD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A168695) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024176114) |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2022-07-15 |