Individual
DR. LISA H. NICOLETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, FNP-BC
Contact information
Practice address
510 E STONER AVE # 5N19, SHREVEPORT, LA 71101-4243
(318) 221-8411
Mailing address
2009 RUBICH LN, SLIDELL, LA 70461-1362
(985) 640-9422
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R869017
MS
363LF0000X
Family Nurse Practitioner
Primary
RN073931-AP03946
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11254
—
LA
Enumeration date
08/15/2005
Last updated
09/14/2023
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