Provider Demographics
NPI:1801145578
Name:KUSKY, NICOLE M (LPN)
Entity type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:M
Last Name:KUSKY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301
Mailing Address - Country:US
Mailing Address - Phone:724-263-6766
Mailing Address - Fax:
Practice Address - Street 1:289 NORTH AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-3512
Practice Address - Country:US
Practice Address - Phone:724-223-7801
Practice Address - Fax:724-223-7802
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN289438164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse