Provider Demographics
NPI:1265722292
Name:RUST, KARIE LYNN (LAC)
Entity type:Individual
Prefix:
First Name:KARIE
Middle Name:LYNN
Last Name:RUST
Suffix:
Gender:F
Credentials:LAC
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 116
Mailing Address - Street 2:
Mailing Address - City:SHARPSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16150-0116
Mailing Address - Country:US
Mailing Address - Phone:216-262-0081
Mailing Address - Fax:
Practice Address - Street 1:100 S DIAMOND ST
Practice Address - Street 2:
Practice Address - City:MERCER
Practice Address - State:PA
Practice Address - Zip Code:16137-1208
Practice Address - Country:US
Practice Address - Phone:724-815-7372
Practice Address - Fax:724-383-4088
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-11
Last Update Date:2022-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK001298171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist