Individual
JACQUELINE R RUSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901-3224
(321) 837-3820
Mailing address
PO BOX 2400, MELBOURNE, FL 32902-2400
(321) 837-3820
(603) 893-8886
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9361702
FL
367500000X
Certified Registered Nurse Anesthetist
COA.11919-NA
OH
Other
Enumeration date
11/24/2010
Last updated
04/30/2019
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