Provider Demographics
NPI:1831571249
Name:HUSAIN, JUANNA RUDSTON (MSN, ACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:JUANNA
Middle Name:RUDSTON
Last Name:HUSAIN
Suffix:
Gender:F
Credentials:MSN, ACNP-BC
Other - Prefix:MS
Other - First Name:JOANNA
Other - Middle Name:RUDSTON
Other - Last Name:MAGNON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:3945 E PARADISE FALLS DRIVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-6687
Mailing Address - Country:US
Mailing Address - Phone:520-290-5888
Mailing Address - Fax:520-290-5551
Practice Address - Street 1:3945 E PARADISE FALLS DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-6687
Practice Address - Country:US
Practice Address - Phone:520-290-5888
Practice Address - Fax:520-290-5551
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704251179163W00000X
TX777844163WC0200X
CA711757163WC0200X
ZZ2020916163WC0200X
TXAP121831363LC0200X
FLARNP9373492363LC0200X
AZAP8246363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1578904470OtherNPI