| Doctor Name: | MS. ANGELA RAE LUSCO |
| NPI Number: | 1114286325 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N., B.S.N. |
| License Number: | 09000577RN |
| Business Practice Address: | 725 W Main St John Day, OR - 978451299 |
| Business Phone Number: | 5416202150 |
| Business Fax Number: | 5415752910 |
| Mailing Address: | 26331 Laycock Creek Rd, MOUNT VERNON |
| State: | OR |
| Postal Code: | 978656197 |
| Phone Number: | 5416202150 |
| Fax Number: | 5415753506 |
| NPI Enumeration Date: | 05/08/2012 |
| NPI Last Update Date: | 05/31/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WH0200X |
| License Number: | 09000577RN |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Home Health |
| Taxonomy Definition: | |