Provider Demographics
NPI:1760150239
Name:RUSING, JESTINE BRASWELL BAXTER (DNP)
Entity Type:Individual
Prefix:
First Name:JESTINE
Middle Name:BRASWELL BAXTER
Last Name:RUSING
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:JESTINE
Other - Middle Name:MARKS BRASWELL
Other - Last Name:BAXTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8501 E ALAMEDA AVE UNIT 1125
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6035
Mailing Address - Country:US
Mailing Address - Phone:909-222-0294
Mailing Address - Fax:
Practice Address - Street 1:1305 NORTH MARTIN AVENUE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85721-6035
Practice Address - Country:US
Practice Address - Phone:520-626-6154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AZ248519163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program