MRS. SUSAN R BRUST PSYCH NP CNS NPI 1952415085

NPI Information

NPI: 1952415085
Provider Name: MRS. SUSAN R BRUST, PSYCH NP, CNS
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
1100 LAKE VIEW DR
WAUSAU, WI
ZIP 54403
Phone: (715) 848-4600
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MRS. Susan R Brust, PSYCH NP, CNS is a psychiatric/mental health nurse practitioner in Wausau, WI with 24 years of experience. MRS. Susan R Brust, PSYCH NP, CNS NPI is 1952415085. 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:

1100 LAKE VIEW DR
WAUSAU, WI
ZIP 54403-799
Phone: (715) 848-4600

The NPI 1952415085 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 8/18/2006 and was last updated on 3/30/2021.

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	363LF0000X	Nurse Practitioner	Family	8103	WISCONSIN	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	8103-33	WISCONSIN	Yes
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	R1306952	MINNESOTA	No

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	1351033600	MEDICAID	MINNESOTA
2	83-60115	OTHER	MINNESOTA	UBH
3	164P4SU	OTHER	MINNESOTA	BCBS GROUP NUMBER
4	125674	OTHER	MINNESOTA	MMSI
5	162P6BR	OTHER	MINNESOTA	BCBS IND NUMBER

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: 4/28/2024

NPI Synchronization or Removal

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