Individual
MISS JANET RUSTIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6138 KENNERLY RD STE 201, JACKSONVILLE, FL 32216-4395
(904) 208-4120
Mailing address
808 S BLACK CHERRY DR, SAINT JOHNS, FL 32259-4099
(908) 415-0202
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26N009399700
NJ
163W00000X
Registered Nurse
ARNP9287785
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9287785
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003349000
—
FL
Enumeration date
05/20/2007
Last updated
08/24/2012
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