Healthcare Provider Details

I. General information

NPI: 1366711285
Provider Name (Legal Business Name): MARIANNE E RUST RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2011
Last Update Date: 12/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 W BRIDGE ST STE 5
YERINGTON NV
89447-1540
US

IV. Provider business mailing address

1665 OLD HOT SPRINGS RD SUITE 157
CARSON CITY NV
89706-0782
US

V. Phone/Fax

Practice location:
  • Phone: 775-463-3191
  • Fax: 775-463-4641
Mailing address:
  • Phone: 775-687-5162
  • Fax: 775-687-5745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN69544
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: