Individual
ADRIENNE RUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
801 7TH AVE, FORT WORTH, TX 76104-2733
(682) 885-1475
(682) 885-7520
Mailing address
900 JEROME ST STE 102, FORT WORTH, TX 76104-3939
(817) 922-0800
(817) 922-0805
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
750214
TX
363LP0200X
Pediatric Nurse Practitioner
AP124540
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346676103
—
TX
Enumeration date
09/24/2013
Last updated
09/06/2022
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