MEDICARE: VICKY D LUSE APRN

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
1	363L00000X	Nurse Practitioner	45228	KS

General Provider Information

NPI Number	:	1134172356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICKY D LUSE APRN

Provider Business Mailing Address
First Line	:	325 MAINE ST
Second Line	:	MSO LIBRARY
City	:	LAWRENCE
State	:	KS
Zip	:	66044-1360
Country	:	US
Telephone Number	:	785-505-2988
Fax Number	:	785-505-5228

Provider Business Practice Location Address
First Line	:	6265 ROCK CHALK DR STE 2700
Second Line	:
City	:	LAWRENCE
State	:	KS
Zip	:	66049-5232
Country	:	US
Telephone Number	:	785-505-5885
Fax Number	:	785-505-5302

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	05/12/2026

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