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1609096510
MARY LUSTER
JACKSON, TN
NPI
1609096510
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: TN LPN0000039076)
Enumeration Date
2007-04-26
Last Update Date
2007-07-08
Business Address
-- MARY LUSTER LPN
804 N PARKWAY
JACKSON, TN 38305-3058
Phone number: 731-423-3020
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Mailing Address
-- MARY LUSTER LPN
25 ROXBURY DR
JACKSON, TN 38305-1682
Phone number: 731-512-3300
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