MEDICARE: SANDRA C LUSK

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	231H00000X	Audiologist	2023021373	MO

General Provider Information

NPI Number	:	1568149763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA C LUSK

Provider Business Mailing Address
First Line	:	9300 DEWITT LOOP
Second Line	:
City	:	FT BELVOIR
State	:	VA
Zip	:	22060-5285
Country	:	US
Telephone Number	:	571-231-2601
Fax Number	:

Provider Business Practice Location Address
First Line	:	CARL R. DARNELL ARMY MEDICAL CENTER
Second Line	:	590 MEDICAL CENTER ROAD
City	:	FORT HOOD
State	:	TX
Zip	:	76544-5060
Country	:	US
Telephone Number	:	254-288-8490
Fax Number	:

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

Provider Enumeration Date	:	06/29/2023
Last Update Date	:	12/04/2025

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Directions to “ SANDRA C LUSK ” Practice Location

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