Provider Demographics
NPI:1942182712
Name:LUSK, CADENCE (LPN)
Entity type:Individual
Prefix:
First Name:CADENCE
Middle Name:
Last Name:LUSK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 HARMONY RD
Mailing Address - Street 2:
Mailing Address - City:SUSQUEHANNA
Mailing Address - State:PA
Mailing Address - Zip Code:18847-7624
Mailing Address - Country:US
Mailing Address - Phone:570-396-5204
Mailing Address - Fax:
Practice Address - Street 1:17 HAYS AVE
Practice Address - Street 2:
Practice Address - City:KIRKWOOD
Practice Address - State:NY
Practice Address - Zip Code:13795-1418
Practice Address - Country:US
Practice Address - Phone:570-396-5204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY353377-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse