Tessa Lynn Lusk
Technician, Personal Care Attendant in Bim, WV. Individual provider (NPI-1).
NPI number1164033858
StatusActive
Last updated in NPPESApr 29, 2022
Details
- NPI
- 1164033858
- Entity type
- Individual (NPI-1)
- Name
- Tessa Lynn Lusk
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 14, 2020
- Certification date
- Apr 29, 2022
- Last updated
- Apr 29, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747P1801X | Technician, Personal Care Attendant | – | – | Yes |
Practice location
57 Gatewood LnBim, WV 25021
Phone 304-470-2448
Mailing address
Po Box 183Bim, WV 25021-0183
Phone 304-470-2448
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