Healthcare Provider Details

I. General information

NPI: 1902801368
Provider Name (Legal Business Name): KARLA M. RUSK APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARLA KING

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 02/24/2021
Certification Date: 02/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 W 10TH AVE
COLUMBUS OH
43210-1240
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-7677
  • Fax: 614-293-5614
Mailing address:
  • Phone: 614-293-7677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.04043
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number04043NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: