Shawnna Gustafson

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

657882-1 Issued in NY

Practice address

177 Gardner St
Fredonia, NY 14063-1634

Phone

(716) 397-7617

NPI assigned

Jun 26, 2016

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 26, 2016.

{
    "created_epoch": "1466899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466899200000",
    "number": "1306297809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 GARDNER ST",
            "city": "FREDONIA",
            "state": "NY",
            "postal_code": "140631634",
            "telephone_number": "716-397-7617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 GARDNER ST",
            "city": "FREDONIA",
            "state": "NY",
            "postal_code": "140631634",
            "telephone_number": "716-397-7617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "SHAWNNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-26",
        "last_updated": "2016-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "657882-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Faye Gilmore, COTA
• Kathleen Zillner Glass, ANP-BC
• Chelsea Marie Gray
• Jonelle Olivia Green, OD
• Kevin P Grzybowski, PHARMD
• Charles William Hannum, D.D.S.
• Melissa Ann Harp, PA
• Hearing Health LLC
• Erin Marie Hellwig, MS, CCC-SLP
• Kevin Hinkley

• All providers in Fredonia, NY
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.