Provider Demographics
NPI:1285479055
Name:LUSK, KIMBERLY JOANNE (RN)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:JOANNE
Last Name:LUSK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNC GREENSBORO SCHOOL OF NURSING
Mailing Address - Street 2:1007 WALKER AVENUE
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27402-6170
Mailing Address - Country:US
Mailing Address - Phone:336-334-5400
Mailing Address - Fax:
Practice Address - Street 1:UNC GREENSBORO SCHOOL OF NURSING
Practice Address - Street 2:1007 WALKER AVENUE
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27402-6170
Practice Address - Country:US
Practice Address - Phone:336-334-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC262585163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine