Individual
MARISA NICHOLE RUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
271 W SOUTHLAKE BLVD, SOUTHLAKE, TX 76092-7049
(972) 200-8148
Mailing address
271 W SOUTHLAKE BLVD STE 120, SOUTHLAKE, TX 76092-7050
(972) 200-8148
(682) 477-3694
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1205173
TX
Other
Enumeration date
04/02/2025
Last updated
09/22/2025
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