| Dalton Lusk, | |
|
3203 E Old Stone Ave, Brookline, MO 65619-9620 | |
| (417) 269-1910 | |
| Not Available |
| Full Name | Dalton Lusk |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 3 Years |
| Location | 3203 E Old Stone Ave, Brookline, Missouri |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609500990 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 2022024064 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Cox Medical Centers | Springfield, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lester E Cox Medical Centers | 5799787784 | 214 |
| Entity Name | Lester E Cox Medical Centers |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053481689 PECOS PAC ID: 5799787784 Enrollment ID: O20070206000485 |
| Mailing Address | Practice Location Address |
|---|---|
| Dalton Lusk, 3203 E Old Stone Ave, Brookline, MO 65619-9620 Ph: () - | Dalton Lusk, 3203 E Old Stone Ave, Brookline, MO 65619-9620 Ph: (417) 269-1910 |
Celeste Renee Andrews, DNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3203 E Old Stone Ave, Brookline, MO 65619 Phone: 417-269-1910 Fax: 417-269-1916 | |
Debrah M. Bridges, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3203 E Old Stone Avenue, Brookline, MO 65619 Phone: 417-269-1910 Fax: 417-269-1916 | |
Renita W. Randall, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3203 E Old Stone Rd, Brookline, MO 65619 Phone: 417-269-1910 Fax: 417-269-1916 | |
Mrs. Sherrie J. Ament-sturtevant, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3203 E Old Stone Ave, Brookline, MO 65619 Phone: 417-269-1910 Fax: 417-269-1916 | |
Leann N Rensch, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3203 E Old Stone Ave, Brookline, MO 65619 Phone: 417-269-1910 Fax: 417-269-1916 | |
Andrea Gullett, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3203 E Old Stone Rd, Brookline, MO 65619 Phone: 417-269-1910 Fax: 417-269-1916 |