Provider Demographics
NPI:1184126799
Name:LUSK, ALICIA
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:LUSK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 W END AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1378
Mailing Address - Country:US
Mailing Address - Phone:615-345-5450
Mailing Address - Fax:888-468-6511
Practice Address - Street 1:1926 10TH AVE N STE 105
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-3300
Practice Address - Country:US
Practice Address - Phone:615-345-5450
Practice Address - Fax:888-468-6511
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9461590163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse