Angela Rae Lusco, R.N., B.S.N.

Individual provider Active NPI Home Health Registered Nurse · John Day, OR

NPI 1114286325 · NPPES record last updated May 31, 2012

Key facts

NPI
1114286325
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Registered Nurse 163WH0200X
License
09000577RN (OR)
Practice address
725 W Main St
John Day, OR 97845-1299
Phone
(541) 620-2150
Fax
(541) 575-2910
NPI assigned
May 8, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
09000577RNORMDHome Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 09000577RN OR Yes

Addresses

Primary practice location

725 W Main St
John Day, OR 97845-1299

Mailing address

26331 Laycock Creek Rd
Mount Vernon, OR 97865-6197
Phone (541) 620-2150

Other providers in John Day, OR

All providers in John Day, OR · Home Health Registered Nurse in Oregon

Sources for this page

Verify at the official NPI Registry.