Provider Demographics
NPI:1134172356
Name:LUSE, VICKY D (APRN)
Entity type:Individual
Prefix:
First Name:VICKY
Middle Name:D
Last Name:LUSE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:325 MAINE ST
Mailing Address - Street 2:MSO LIBRARY
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-1360
Mailing Address - Country:US
Mailing Address - Phone:785-505-2988
Mailing Address - Fax:785-505-5228
Practice Address - Street 1:1130 W 4TH ST STE 3200
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1346
Practice Address - Country:US
Practice Address - Phone:785-505-5885
Practice Address - Fax:785-505-5302
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2023-10-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS45228363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSKA1087015Medicare PIN
KSKA1007015Medicare PIN
KS160702Medicare ID - Type UnspecifiedKS MEDICARE #