Rebecca Jo Gustafson, ND
Individual provider Active NPI Naturopath · Viroqua, WI
NPI 1144068552 · NPPES record last updated Jul 18, 2024
Key facts
- NPI
- 1144068552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Naturopath 175F00000X
- License
- 6064-170 (WI)
- Practice address
- 114 FS Dr Ste a
Viroqua, WI 54665-2248 - Phone
- (608) 214-2888
- NPI assigned
- Jul 18, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6064-170 | WI | MD | Naturopath |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | 6064-170 | WI | Yes |
Addresses
Primary practice location
114 FS Dr Ste a
Viroqua, WI 54665-2248
Mailing address
524 E South St
Viroqua, WI 54665-2048
Phone (608) 214-2888
Other providers in Viroqua, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.