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NPI Code Detail

MEDICARE: KRISTA A LUSSIER FNP

MEDICARE: KRISTA A LUSSIER FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP3229AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00763100OTHERAZRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083853352
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTA A LUSSIER FNP
Provider Business Mailing Address
First Line : 10200 GRAND CENTRAL AVE STE 220
Second Line :
City : OWINGS MILLS
State : MD
Zip : 21117-4366
Country : US
Telephone Number : 602-222-1900
Fax Number :
Provider Business Practice Location Address
First Line : 17300 N PERIMETER DR STE 220
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85255-6703
Country : US
Telephone Number : 480-661-2661
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2009
Last Update Date : 12/09/2025

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Directions to “ KRISTA A LUSSIER FNP” Practice Location

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