Individual
MS. JESSICA LUSK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 N 4TH AVE STE 102, ANN ARBOR, MI 48104-5503
(734) 323-5803
Mailing address
555 TOWNER ST, P.O. BOX 915, YPSILANTI, MI 48198-5752
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
4704278764
MI
Other
Enumeration date
01/13/2011
Last updated
01/13/2011
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