Individual
FAITH A. GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1475 WEBB ST, CUMBERLAND, WI 54829-9187
(717) 822-2231
(715) 822-2023
Mailing address
1475 WEBB ST, CUMBERLAND, WI 54829-9187
(717) 822-2231
(715) 822-2023
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1677-023
WI
363AS0400X
Surgical Physician Assistant
1677-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41981700
—
WI
Enumeration date
06/30/2005
Last updated
09/11/2025
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