Individual
DR. FLEETWOOD LOUSTALOT III
Active
Individual
DR. FLEETWOOD LOUSTALOT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, NP-C, PHD
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R864143
MS
363LF0000X
Family Nurse Practitioner
Primary
RN206938
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0126734
—
MS
01
—
206938
LICENSE
GA
01
—
R864143
LICENSE NUMBER
MS
Enumeration date
05/04/2006
Last updated
10/09/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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