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Individual

MR. KRISTINE ELIZABETH RUSTAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, BSN

Contact information

Practice address
105 MAIN ST, SOUTH PORTLAND, ME 04106-2621
(207) 741-2624
(207) 741-2972
Mailing address
41 LEIGHTON RD, YARMOUTH, ME 04096-7712
(207) 847-9272

Taxonomy

Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
RO46385
ME

Other

Enumeration date
03/09/2007
Last updated
07/08/2007
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