Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | DEM-LD-10140248 | OR |
NPI | 1083918304 |
---|---|
Provider Name | Erin M Lusk |
First Address | Eugene, OR 97402-3522 |
Second Address | Eugene, OR 97402-3522 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2010 |
Last Update Date | 29/12/2010 |