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Individual

COREY D RUSTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
1814 WESTCHESTER DR, STE 301, HIGH POINT, NC 27262-7299
(336) 802-2025
(336) 802-2026
Mailing address
1701 WESTCHESTER DR, STE 850, HIGH POINT, NC 27262-7008
(336) 802-2400
(336) 802-2534

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
01113
NC
363L00000X
Nurse Practitioner
Primary
5001113
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1212660004
DME
NC
05
7004782
NC
Enumeration date
04/28/2006
Last updated
03/09/2016
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