Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kellie J Lustenberger, NP

Individual provider Family Nurse Practitioner · NPI 1295923779

Kellie J Lustenberger, NP is a Nurse Practitioner in Carbondale, Illinois. Qualified in 2007, 19 years ago. Practices with Southern Illinois Ob-Gyn Associates SC, an 8-clinician group. Licensed in Illinois.

Years since qualifying
19
Licensed in
IL
In the registry since
2007
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

305 W Jackson Ste 100 New Horizons Obstetrics & Gynecology
Carbondale, IL 62901
Phone: (618) 457-0404
Fax: (618) 457-0440
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 209006728 (IL)

Record details

NPI number1295923779
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedOctober 9, 2007
Last updated in NPPESMay 14, 2008

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Southern Illinois Ob-Gyn Associates Sc — 8 clinicians
Accepts Medicare assignment Not indicated

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