Healthcare Provider Details

I. General information

NPI: 1982450037
Provider Name (Legal Business Name): RUSTI QUARLES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 POWELL PL # 1441
NASHVILLE TN
37204-3622
US

IV. Provider business mailing address

1603 22ND AVE N UNIT B
NASHVILLE TN
37208-2344
US

V. Phone/Fax

Practice location:
  • Phone: 866-719-9611
  • Fax:
Mailing address:
  • Phone: 719-924-0270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: