Individual
MR. STEPHEN KEITH LUSK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN-CRNA
Contact information
Practice address
501 MORRIS ST, CHARLESTON, WV 25301-1326
(304) 388-6220
(304) 388-3604
Mailing address
3204 VIRGINIA AVE SE, CHARLESTON, WV 25304
(304) 342-7878
(304) 388-3604
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN54395
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2602990000
—
WV
05
—
P00087015
—
WV
Enumeration date
10/26/2006
Last updated
04/26/2019
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