Individual
DEBRA K LUSTIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8778 MADISON AVE, SUITE 200, INDIANAPOLIS, IN 46227-7204
(317) 888-9669
(317) 885-7966
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71002966A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200951000
—
IN
Enumeration date
07/20/2009
Last updated
06/23/2023
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