Basic Information
Provider Information
NPI: 1205115136
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARMBRUSTER
FirstName: REBECCA
MiddleName: JOY
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8170 33RD AVE S
Address2:  
City: MINNEAPOLIS
State: MN
PostalCode: 554254516
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 640 JACKSON ST
Address2:  
City: SAINT PAUL
State: MN
PostalCode: 551012502
CountryCode: US
TelephoneNumber: 6512543456
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/09/2011
LastUpdateDate: 03/08/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/08/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XR1530883MNN Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 
367500000X254MNY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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