Individual
DALTON ROBERT CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
8445 LINE AVE, SHREVEPORT, LA 71106-5925
(318) 703-5655
Mailing address
625 DUMAINE DR, BOSSIER CITY, LA 71111-6277
(318) 751-1246
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
220441
LA
Other
Enumeration date
07/12/2021
Last updated
07/12/2021
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