Provider Demographics
NPI:1467975490
Name:PUST, JOANNA CLAIRE (TM, CPM, LM (WI))
Entity type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:CLAIRE
Last Name:PUST
Suffix:
Gender:F
Credentials:TM, CPM, LM (WI)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1367 TAFT ST S
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MN
Mailing Address - Zip Code:55008-9315
Mailing Address - Country:US
Mailing Address - Phone:763-898-0925
Mailing Address - Fax:763-312-2036
Practice Address - Street 1:1367 TAFT ST S
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MN
Practice Address - Zip Code:55008-9315
Practice Address - Country:US
Practice Address - Phone:763-898-0925
Practice Address - Fax:763-312-2036
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-21
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
176B00000X
WI273-49176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife