Kasey Maureen Lustik

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

APRN11029454 Issued in FL

Practice address

630 W Plymouth Ave
Deland, FL 32720-3260

Phone

(386) 734-3654

NPI assigned

Nov 2, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kasey Maureen Brent Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1235902198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W PLYMOUTH AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W PLYMOUTH AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203260",
            "telephone_number": "386-734-3654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTIK",
        "first_name": "KASEY",
        "middle_name": "MAUREEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-02",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11029454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KASEY",
            "last_name": "BRENT",
            "middle_name": "MAUREEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mason Lowe, RMFTI
• Shawna Lucas
• Rita A Lunardi, LMT
• Melissa I Lundell, LMHC
• Sara Alynn Lunsford, PHARMD
• Lyle E Wadsworth MD PA
• Anika Lynch
• Susan Patricia Lynch, APRN
• M. Wharry, Inc.
• Morgan Macintyre, DO

• Acute Care Nurse Practitioner in Deland, FL
• Providers in Deland, FL by specialty
• Acute Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.