Individual
MRS. OLIVIA NICOLE LUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5225 CLEVELAND RD STE B, WOOSTER, OH 44691-5541
(300) 845-4151
(330) 845-4152
Mailing address
1447 RUMBAUGH CIR, WOOSTER, OH 44691-3009
(330) 635-2782
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.006500
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/27/2020
Last updated
11/01/2024
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