DEBRA ANN RUSTAD RN, CNP
NPI 1487659587
Nurse Practitioner - Gerontology in St Louis Park, MN

Active since June 15, 2005
3850 PARK NICOLLET BLVD, PARK NICOLLET CLINIC--SENIOR SERVICES-- 3RD FLOOR, ST LOUIS PARK, MN 55416(952) 993-5041(952) 993-3236 Get Directions Write a Review

NPPES record last updated: March 18, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Debra Ann Rustad Rn, Cnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEBRA ANN RUSTAD RN, CNP (NPI 1487659587) is an individual gerontology provider in St Louis Park, Minnesota, licensed in Minnesota (R092748-4) and active in the NPI registry since June 2005.

NPPES Registry Identity

NPI1487659587
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameDEBRA ANN RUSTADCredential: RN, CNP
Location Address3850 PARK NICOLLET BLVD, PARK NICOLLET CLINIC--SENIOR SERVICES-- 3RD FLOORSt Louis Park, MN 55416-2527
Mailing Address8170 33rd Ave S # Ms 21110qBloomington, MN 55425-4516
Fax(952) 993-3236
Sole ProprietorYes
Enumeration DateJune 15, 2005
Last NPPES UpdateMarch 18, 2021
NPPES CertifiedMarch 18, 2021
NPI 1487659587 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License Licensed in MN · R092748-4
3850 PARK NICOLLET BLVD, St Louis Park, MN 55416

Other Identifiers 1

Medicaid090529100MN

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Physician Assistant
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Physician Assistant
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Family Medicine
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Internal Medicine
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Family Medicine
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Pediatrics
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Durable Medical Equipment & Medical Supplies
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Debra Rustad's NPI number?

The NPI number for Debra Rustad is 1487659587. It was assigned to this individual provider in the NPPES registry on June 15, 2005.

Where is Debra Rustad located?

Debra Rustad practices at 3850 Park Nicollet Blvd Park Nicollet Clinic--Senior Services-- 3rd Floor, St Louis Park, MN 55416. The listed phone number is (952) 993-5041.

What is Debra Rustad's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

When was this NPI record last updated?

The NPPES record for Debra Rustad was last updated on March 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.