Faith A Gustafson (NPI# 1356348858, PAC ID# 5698676062) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1356348858 |
| PAC ID by PECOS | 5698676062 |
| Professional Enrollment ID | I20040119000172 |
| Full Name | Faith A Gustafson |
| Organization Legal Name | ST. CROIX REGIONAL MEDICAL CENTER |
| Address |
1504 190th Ave Balsam Lake WI 54810-7102 |
| Phone Number | 7158253278 |
| Gender | F |
| Credential | PA |
| Graduation Year | 2002 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 9335032184 |
| Number of Group Practice Members | 166 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 521337 | ST CROIX REGIONAL MEDICAL CTR |
| Address | Phone | Organization |
|---|---|---|
| 1504 190th Ave, Balsam Lake, WI 54810-7102 | 7158253278 | ST. CROIX REGIONAL MEDICAL CENTER |
| Organization Legal Name | ST. CROIX REGIONAL MEDICAL CENTER |
| Physicians | 74 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melissa Lynn Hall | Family Medicine | St. Croix Regional Medical Center | 12375 Lindstrom Ln, Lindstrom, MN 55045-9551 |
| Wendy A Nunes | Urology | St. Croix Regional Medical Center | 235 E State St, St Croix Falls, WI 54024-4117 |
| Colleen E Erb | Psychologist, Clinical | St. Croix Regional Medical Center | 235 E State St, St Croix Falls, WI 54024-4117 |
| Jenna B Mazour | Nurse Practitioner | St. Croix Regional Medical Center | 235 E State St, St Croix Falls, WI 54024-4117 |
| Claudio F Nunes | General Surgery | St. Croix Regional Medical Center | 235 E State St, St Croix Falls, WI 54024-4117 |
| Muhammad Talha Khan | Pulmonary Disease | St. Croix Regional Medical Center | 12375 Lindstrom Ln, Lindstrom, MN 55045-9551 |
| Marisa A Spencer | Gastroenterology | St. Croix Regional Medical Center | 235 E State St, St Croix Falls, WI 54024-4117 |
| Joann C Litkey | Emergency Medicine | St. Croix Regional Medical Center | 235 E State St, St Croix Falls, WI 54024-4117 |
| Patricia A Fettes | Psychologist, Clinical | St. Croix Regional Medical Center | 12375 Lindstrom Ln, Lindstrom, MN 55045-9551 |
| Dominic F Frecentese | Diagnostic Radiology | St. Croix Regional Medical Center | 235 E State St, St Croix Falls, WI 54024-4117 |
| Street Address |
1504 190TH AVE |
| City | BALSAM LAKE |
| State | WI |
| Zip | 54810-7102 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bradley A Kothlow | Chiropractic | 109 Main St, Balsam Lake, WI 54810-2449 | |
| James A Rugowski | Psychiatry | 100 Polk County Plz, Suite 50, Balsam Lake, WI 54810-9097 |
| City | BALSAM LAKE |
| Zip Code | 54810 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | BALSAM LAKE + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Faith A Gustafson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.