Provider Demographics
NPI:1114819463
Name:KUSTER, ELIZABETH IRENE (RN)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:IRENE
Last Name:KUSTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 354
Mailing Address - Street 2:
Mailing Address - City:CABOOL
Mailing Address - State:MO
Mailing Address - Zip Code:65689-0354
Mailing Address - Country:US
Mailing Address - Phone:417-962-4906
Mailing Address - Fax:
Practice Address - Street 1:348 OZARK ST
Practice Address - Street 2:
Practice Address - City:CABOOL
Practice Address - State:MO
Practice Address - Zip Code:65689-7403
Practice Address - Country:US
Practice Address - Phone:417-962-4906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024002280163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse