IndividualActive
Tina Lusk, RN
NPI 1417216417 · Neonatal Intensive Care Registered Nurse · Grand Terrace, CA
Provider details
- NPI number
- 1417216417
- Entity type
- Individual
- Primary specialty
- Neonatal Intensive Care Registered NurseNursing Service Providers
- Credential
- RN
- Sex
- Female
- Sole proprietor
- Yes
- License
- 540788 (CA)
Specialties & taxonomies
Nursing Service Providers
Practice location
22667 Pico St
Grand Terrace, CA 92313-5723
Phone: (909) 514-1013
Approximate (ZIP-level) locationGet directions
Mailing address
22667 Pico St
Grand Terrace, CA 92313-5723
Registry dates
- Enumerated
- 2012-05-10
- Last updated
- 2012-05-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.