Healthcare Provider Details

I. General information

NPI: 1942843370
Provider Name (Legal Business Name): AMY RICHARDS LUSK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2019
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4805 MONTGOMERY RD STE 210
CINCINNATI OH
45212-2280
US

IV. Provider business mailing address

4805 MONTGOMERY RD STE 210
CINCINNATI OH
45212-2280
US

V. Phone/Fax

Practice location:
  • Phone: 513-241-2370
  • Fax: 513-241-6053
Mailing address:
  • Phone: 513-241-2370
  • Fax: 513-852-8525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP025252
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: