Provider Demographics
NPI:1336893650
Name:GUSTOVICH, TRISSA RHEA (APRN)
Entity type:Individual
Prefix:
First Name:TRISSA
Middle Name:RHEA
Last Name:GUSTOVICH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 W PITTSBURGH ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-2239
Mailing Address - Country:US
Mailing Address - Phone:724-832-4450
Mailing Address - Fax:724-830-6669
Practice Address - Street 1:532 W PITTSBURGH ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2239
Practice Address - Country:US
Practice Address - Phone:724-832-4450
Practice Address - Fax:724-830-6669
Is Sole Proprietor?:No
Enumeration Date:2022-02-06
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP024758363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily