Provider Demographics
NPI:1154113819
Name:LUSANGA, BABETTE A
Entity type:Individual
Prefix:
First Name:BABETTE
Middle Name:A
Last Name:LUSANGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 MARINER WAY # 1016
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9437
Mailing Address - Country:US
Mailing Address - Phone:203-578-6083
Mailing Address - Fax:
Practice Address - Street 1:201 MARINER WAY # 1016
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-9437
Practice Address - Country:US
Practice Address - Phone:203-578-6083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion