Individual provider Active NPI

Shawna Marie Lusk, APRN-CNP (FNP)

  • Family Nurse Practitioner
  • Clendenin, WV
National Provider Identifier
1336065044
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
127018 Issued in WV
Practice address
107 Koontz Ave Ste 200
Clendenin, WV 25045-9581
Phone
(304) 548-7272
Fax
(888) 987-8014
NPI assigned
Jun 26, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 127018 WV Primary

Addresses

Primary practice location

107 Koontz Ave Ste 200
Clendenin, WV 25045-9581

Mailing address

104 Alex LN
Charleston, WV 25304-2952
Phone (304) 734-2040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1782432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1336065044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 ALEX LN",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042952",
            "telephone_number": "304-734-2040",
            "fax_number": "304-734-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 KOONTZ AVE STE 200",
            "city": "CLENDENIN",
            "state": "WV",
            "postal_code": "250459581",
            "telephone_number": "304-548-7272",
            "fax_number": "888-987-8014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSK",
        "first_name": "SHAWNA",
        "middle_name": "MARIE",
        "credential": "APRN-CNP (FNP)",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-26",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "127018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clendenin, WV

Sources for this page

Verify at the official NPI Registry.