Individual provider · Type 1 NPI

Tira Brust

Student in an Organized Health Care Education/Training Program · Mequon, WI

NPI number 1861333254 Active

Practice location

12800 N Lake Shore Dr
Mequon, WI 53097-2418

Call (262) 243-5700 Map

Mailing address

101 S Tower Ln
Saukville, WI 53080-2502

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1861333254

Tira Brust's National Provider Identifier is 1861333254, issued on Apr 2, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Mequon, WI. The record was last updated on Apr 2, 2026.