Individual
DUSTIN ROSS CARLISLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
1811 E BERT KOUNS INDUSTRIAL LOOP STE 210, SHREVEPORT, LA 71105-5740
(318) 212-3858
(318) 212-3958
Mailing address
1811 E BERT KOUNS INDUSTRIAL LOOP STE 210, SHREVEPORT, LA 71105-5740
(318) 212-3858
(318) 212-3958
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
232197
LA
Other
Enumeration date
04/09/2024
Last updated
11/05/2024
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