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1083467104
DUSTIN ROSS CARLISLE
SHREVEPORT, LA
NPI
1083467104
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: LA 232197)
Enumeration Date
2024-04-09
Last Update Date
2024-04-12
Business Address
DUSTIN ROSS CARLISLE NP-C
1800 BUCKNER ST STE C120
SHREVEPORT, LA 71101-4453
Phone number: 318-227-8899
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Mailing Address
DUSTIN ROSS CARLISLE NP-C
1800 BUCKNER ST STE C120
SHREVEPORT, LA 71101-4453
Phone number: 318-773-7202
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