CAROLYN BETH CUSTER LAC NPI 1679872576

NPI Information

NPI: 1679872576
Provider Name: CAROLYN BETH CUSTER, LAC
Classification: Acupuncturist - 171100000X
Entity Type: Individual
Address:
112 S MAIN ST STE 2A
JEFFERSON, WI
ZIP 53549
Phone: (920) 674-6707
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Carolyn Beth Custer, LAC is an acupuncturist in Jefferson, WI. The provider is an acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia. Carolyn Beth Custer, LAC NPI is 1679872576. 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:

112 S MAIN ST STE 2A
JEFFERSON, WI
ZIP 53549-657
Phone: (920) 674-6707
Fax: (920) 674-6707

The enumeration date for this NPI number is 3/18/2011 and was last updated on 3/13/2020.

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
1	171100000X	Acupuncturist		636-55	WISCONSIN	Yes

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
1	1679872576	OTHER	WISCONSIN	CMS

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: 5/5/2024

NPI Synchronization or Removal

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