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General NPI Number Information
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NPI Number | 1114847878
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Entity Type | Individual
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Provider Name | ELIZABETH RUST
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Gender |
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Dates
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Enumeration Date | 07/21/2026
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Last Update Date | 07/21/2026
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Provider Practice Location Address
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Address Line | 9000 W WISCONSIN AVE
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City | MILWAUKEE
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State | WI
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Zip | 53226-4874
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Country | US
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Telephone | 262-909-4928
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Fax |
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Provider Business Mailing Address
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Address Line | 20400 POPLAR CREEK PKWY UNIT 417
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City | BROOKFIELD
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State | WI
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Zip | 53045-2243
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Country | US
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Telephone | 262-909-4928
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Fax |
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 261426-30
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License Number State | WI
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