MEDICARE: DESIREE CORRINE LUSK

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	3747P1801X	Personal Care Attendant
2	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
3	376J00000X	Homemaker

General Provider Information

NPI Number	:	1215727466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DESIREE CORRINE LUSK

Provider Business Mailing Address
First Line	:	6208 OSAGE DR
Second Line	:
City	:	FAIRFIELD TOWNSHIP
State	:	OH
Zip	:	45011-7638
Country	:	US
Telephone Number	:	513-256-0281
Fax Number	:

Provider Business Practice Location Address
First Line	:	6208 OSAGE DR
Second Line	:
City	:	FAIRFIELD TOWNSHIP
State	:	OH
Zip	:	45011-7638
Country	:	US
Telephone Number	:	513-256-0281
Fax Number	:

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

Provider Enumeration Date	:	05/10/2025
Last Update Date	:	05/13/2025

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Directions to “ DESIREE CORRINE LUSK ” Practice Location

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