Individual
KELSIE JEAN RUSTAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
600 PETERSON PKWY, NEW LONDON, MN 56273-7823
(320) 444-8287
Mailing address
600 PETERSON PKWY, NEW LONDON, MN 56273-7823
(320) 354-2222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14572
MN
Other
Enumeration date
07/01/2022
Last updated
10/16/2023
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