Individual
DUSTIN ALLEN LOGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ANP
Contact information
Practice address
12902 PLANK RD, BAKER, LA 70714-4911
(225) 369-7006
(225) 774-2827
Mailing address
12902 PLANK RD, BAKER, LA 70714-4911
(225) 774-0733
(225) 774-7777
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
06078
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2110691
—
LA
Enumeration date
01/11/2010
Last updated
10/10/2024
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