Vanessa Rusin, ATC
Individual provider Active NPI Athletic Trainer · Simpson, PA
NPI 1154556629 · NPPES record last updated May 27, 2009
Key facts
- NPI
- 1154556629
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- RT004536 (PA)
- Practice address
- 126 Jefferson St
Simpson, PA 18407-1210 - Phone
- (570) 575-4724
- NPI assigned
- May 27, 2009
- 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 |
|---|---|---|---|
| RT004536 | PA | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | RT004536 | PA | Yes |
Addresses
Primary practice location
126 Jefferson St
Simpson, PA 18407-1210
Mailing address
126 Jefferson St
Simpson, PA 18407-1210
Phone (570) 575-4724
Other providers in Simpson, PA
- Cecelia Cortes
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- Jason Edward Jablonowski
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- Mary Ann Kelly
- The Retreat at White Birch LLC
All providers in Simpson, PA · Athletic Trainer in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2009. 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.