Healthcare Provider Details

I. General information

NPI: 1760150239
Provider Name (Legal Business Name): JESTINE BRASWELL BAXTER RUSING DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESTINE MARKS BRASWELL BAXTER

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SOUTHPARK DR
LITTLETON CO
80120-5654
US

IV. Provider business mailing address

1000 SOUTHPARK DR
LITTLETON CO
80120-5654
US

V. Phone/Fax

Practice location:
  • Phone: 303-744-1065
  • Fax:
Mailing address:
  • Phone: 303-744-1065
  • Fax: 303-733-1699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number248519
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN.1000631-NP
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: