SUZANNE S RUSK PNP NPI 1528152915

NPI Information

  • NPI: 1528152915
  • Provider Name: SUZANNE S RUSK, PNP
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 5200 FAIRVIEW BOULEVARD
    FAIRVIEW LAKES PEDIATRICS
    WYOMING, MN
    ZIP 55092
  • Phone: (651) 682-7340

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NPI Details

Suzanne S Rusk, PNP is a pediatrics nurse practitioner in Wyoming, MN. Suzanne S Rusk, PNP NPI is 1528152915. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5200 FAIRVIEW BOULEVARD
FAIRVIEW LAKES PEDIATRICS
WYOMING, MN
ZIP 55092
Phone: (651) 682-7340
Fax: (651) 982-7349

The NPI 1528152915 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/3/2006 and was last updated on 12/26/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0200XNurse PractitionerPediatricsR-111703-1MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1P81385MEDICARE UPIN
242088721MEDICAIDNEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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