Provider Demographics
NPI:1154610483
Name:LUSK, LAUREN A (MD)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:A
Last Name:LUSK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7330 FERN AVENUE
Mailing Address - Street 2:SUITE 704
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105
Mailing Address - Country:US
Mailing Address - Phone:318-798-8260
Mailing Address - Fax:318-798-8263
Practice Address - Street 1:7330 FERN AVENUE
Practice Address - Street 2:SUITE 704
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105
Practice Address - Country:US
Practice Address - Phone:318-798-8260
Practice Address - Fax:318-798-8263
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAMD.2058502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry