Provider Demographics
NPI:1932277043
Name:FAUST, SCOTT T (NP)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:T
Last Name:FAUST
Suffix:
Gender:M
Credentials:NP
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Mailing Address - Street 1:640 JACKSON ST
Mailing Address - Street 2:MS 11503L
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-2502
Mailing Address - Country:US
Mailing Address - Phone:651-254-2005
Mailing Address - Fax:651-254-1519
Practice Address - Street 1:640 JACKSON ST
Practice Address - Street 2:MS 11503L
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2502
Practice Address - Country:US
Practice Address - Phone:651-254-2005
Practice Address - Fax:651-254-1519
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2013-06-24
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Provider Licenses
StateLicense IDTaxonomies
MNR1824421363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner