Pamela A Rustvang, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R26123 Issued in ND

Practice address

1000 S Columbia Rd
Grand Forks, ND 58201-4032

Phone

(701) 780-5000

NPI assigned

Jul 22, 2006

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)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clinic Pharmacy Inc

  • Community/Retail Pharmacy
  • Devils Lake, ND
  • NPI 1184718876
  NPD (past)

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1851312078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 S COLUMBIA RD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014032",
            "telephone_number": "701-780-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S COLUMBIA RD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014032",
            "telephone_number": "701-780-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSTVANG",
        "first_name": "PAMELA",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R26123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sue Ann Russell, PH.D.
• Tiffany D Russell
• Kathryn Gail Rustebakke, PT
• Heather Lea Rusten, DO
• Daniel Richard Rustvang, FNP-C
• RX Consult
• Casey J Ryan, MD
• Ken Ryan, MD
• Jenna C Rydquist, PTA
• Karley Rygg

• Nurse Practitioner in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Nurse Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; 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.