Gustafson, Faith A.

Gustafson, Faith A. is an individual health care provider with primary practice located at 1475 Webb St , Cumberland WI 54829-9187. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Gustafson, Faith A. can be contacted via phone (717) 822-2231.

Contact Information

Primary practice address
1475 Webb St Cumberland WI 54829-9187
Phone: (717) 822-2231
Fax: (715) 822-2023
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 1677-023 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 1677-023 Wisconsin

Profile Details

NPI number 1356348858
LBN Legal business name Gustafson, Faith A.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2005
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356348858 NPPES
Wisconsin MEDICAID 41981700

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