Susan Stephanie Gustafson, LPN is a
Licensed Practical Nurse based in Forest Lake, Minnesota. Susan Stephanie Gustafson is licensed to practice in Minnesota (license number L71970-2) and her current practice location is
7951 250th St, Forest Lake, Minnesota. She can be reached at her office (for appointments etc.) via phone at
(651) 231-2048.
NPI number for Susan Stephanie Gustafson is 1205214350 and her current mailing address is 7951 250th St, Forest Lake, Minnesota. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1205214350.
Provider's Profile
| Full Name | Susan Stephanie Gustafson |
|---|
| Gender | Female |
|---|
| Speciality | Licensed Practical Nurse |
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| Location | 7951 250th St, Forest Lake, Minnesota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1205214350
- Provider Enumeration Date: 05/09/2015
- Last Update Date: 05/09/2015
Medical Identifiers
Medical identifiers for Susan Stephanie Gustafson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1205214350 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164W00000X | Licensed Practical Nurse | L71970-2 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Susan Stephanie Gustafson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Susan Stephanie Gustafson, LPN
7951 250th St,
Forest Lake, MN 55025-8370
Ph: (651) 231-2048 | Susan Stephanie Gustafson, LPN
7951 250th St,
Forest Lake, MN 55025-8370
Ph: (651) 231-2048 |
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