Ann Marie Rusnak, AGNP-C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

SPO27128 Issued in PA

Practice address

103 Amelia Ave
Greenfield Township, PA 18407-3702

Phone

(570) 840-3169

NPI assigned

Nov 28, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Ann Marie McGowan Rusnak Professional name

Electronic endpoints 1

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.

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1841900354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 AMELIA AVE",
            "city": "GREENFIELD TOWNSHIP",
            "state": "PA",
            "postal_code": "184073702",
            "telephone_number": "570-840-3169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 AMELIA AVE",
            "city": "GREENFIELD TOWNSHIP",
            "state": "PA",
            "postal_code": "184073702",
            "telephone_number": "570-840-3169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSNAK",
        "first_name": "ANN MARIE",
        "name_prefix": "Mrs.",
        "credential": "AGNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-28",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SPO27128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Doxy.com",
            "affiliation": "N",
            "address_1": "103 Amelia Ave",
            "city": "Greenfield Township",
            "state": "PA",
            "country_code": "US",
            "postal_code": "184073702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANN MARIE",
            "last_name": "MCGOWAN RUSNAK",
            "prefix": "MRS.",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kimberly Mazzoni, RDLDN
• Melissa McPartland, D.C.
• Alanna O'Malley
• Mary Retzbach
• Cathy Rivenburgh
• Kiersten Scott
• Colin Christopher Striefsky, PTA
• Matthew Wayne Woolcock, DMD

• Gerontology Nurse Practitioner in Greenfield Township, PA
• Providers in Greenfield Township, PA by specialty
• Gerontology Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; 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.