Tessa Lynn Lusk
Individual provider Active NPI Personal Care Attendant · Bim, WV
NPI 1164033858 · NPPES record last updated Apr 29, 2022
Key facts
- NPI
- 1164033858
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 57 Gatewood LN
Bim, WV 25021 - Phone
- (304) 470-2448
- NPI assigned
- Aug 14, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Yes |
Addresses
Primary practice location
57 Gatewood LN
Bim, WV 25021
Mailing address
PO Box 183
Bim, WV 25021-0183
Phone (304) 470-2448
Other providers in Bim, WV
All providers in Bim, WV · Personal Care Attendant in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.