Provider Demographics
NPI:1427250232
Name:GASPAR-RUST, CINDY C (PNP)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:C
Last Name:GASPAR-RUST
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:C
Other - Last Name:RUST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PNP
Mailing Address - Street 1:2953 E DOVER ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-6934
Mailing Address - Country:US
Mailing Address - Phone:480-981-3308
Mailing Address - Fax:
Practice Address - Street 1:2953 E DOVER ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85213-6934
Practice Address - Country:US
Practice Address - Phone:480-981-3308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN049159363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics