Lindsey Ruth Gustafson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024180224 Issued in VA

Practice address

2054 Meadow Springs Dr
Vienna, VA 22182-3771

Phone

(630) 886-7896

NPI assigned

Sep 25, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1760099642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2054 MEADOW SPRINGS DR",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823771",
            "telephone_number": "630-886-7896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2054 MEADOW SPRINGS DR",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823771",
            "telephone_number": "630-886-7896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "LINDSEY",
        "middle_name": "RUTH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-25",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024180224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Juanli Guo, DMD, MS, PHD, FACP
• Run Guo, LAC
• Diksha Gupta
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• Noelle Ha
• Sayeeda Chowdhury Habib, RDN/LDN

• All providers in Vienna, VA
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; 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.