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General NPI Number Information
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NPI Number | 1386891372
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Entity Type | Individual
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Provider Name | ATNENA LEANN LUSTER DNP, FNP
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Gender | Female
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Dates
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Enumeration Date | 08/21/2008
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Last Update Date | 05/09/2018
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Provider Practice Location Address
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Address Line | 201 GREENBRIER BLVD
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City | COVINGTON
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State | LA
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Zip | 70433-7236
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Country | US
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Telephone | 985-771-2221
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Fax |
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Provider Business Mailing Address
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Address Line | 117 AUTUMN CREEK DR
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City | MADISONVILLE
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State | LA
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Zip | 70447-3603
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Country | US
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Telephone | 901-288-5200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 00141366
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP05600
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License Number State | LA
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