Active NPI
Jennifer C Rustin, RN
- Registered Nurse
- Kirklin, IN
National Provider Identifier
1407725088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 28205652A
- Practice address
- 307 S Main St
Kirklin, IN 46050-9735 - Phone
- (317) 840-3697
- NPI assigned
- Nov 3, 2025
- Last updated
- Nov 3, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 28205652A | IN | Primary |
Addresses
Primary practice location
307 S Main St
Kirklin, IN 46050-9735
Mailing address
PO Box 271
Kirklin, IN 46050-0271
Phone (317) 840-3697
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28205652A | IN | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762128000000",
"number": "1407725088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 271",
"city": "KIRKLIN",
"state": "IN",
"postal_code": "460500271",
"telephone_number": "317-840-3697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 S MAIN ST",
"city": "KIRKLIN",
"state": "IN",
"postal_code": "460509735",
"telephone_number": "317-840-3697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSTIN",
"first_name": "JENNIFER",
"middle_name": "C",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-11-03",
"last_updated": "2025-11-03",
"certification_date": "2025-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IN",
"license": "28205652A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirklin, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.