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General NPI Number Information
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NPI Number | 1841844172
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Entity Type | Individual
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Provider Name | DANIEL BRYAN RUST DNP, CRNA
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Gender | Male
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Dates
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Enumeration Date | 07/25/2019
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Last Update Date | 09/27/2021
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Provider Practice Location Address
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Address Line | 6350 E 2ND ST
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City | CASPER
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State | WY
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Zip | 82609-4264
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Country | US
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Telephone | 307-232-6600
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Fax |
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Provider Business Mailing Address
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Address Line | 411 N FOREST DR UNIT 50752
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City | CASPER
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State | WY
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Zip | 82605-0108
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Country | US
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Telephone | 520-628-0599
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 234139-30
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28235362A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041.452348
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 44308
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License Number State | WY
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