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General NPI Number Information
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NPI Number | 1033430426
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Entity Type | Individual
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Provider Name | LINDSEY ANNE RUSK PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/19/2010
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Last Update Date | 08/26/2019
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Provider Practice Location Address
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Address Line | MEDICAL CENTER BLVD
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City | WINSTON SALEM
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State | NC
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Zip | 27157-9875
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Country | US
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Telephone | 336-716-0209
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Fax | 336-716-0030
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Provider Business Mailing Address
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Address Line | 1 MEDICAL CENTER BLVD
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City | WINSTON SALEM
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State | NC
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Zip | 27157-0447
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Country | US
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Telephone | 336-716-0209
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Fax | 336-716-0030
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-04543
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License Number State | NC
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