Individual
SUSAN M DUNGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1811 E BERT KOUNS, SUITE 100, SHREVEPORT, LA 71105
(318) 222-3695
(318) 424-0717
Mailing address
1844 GLEN COVE DR, BENTON, LA 71006-8414
(318) 965-4341
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN089268 AP04806
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1409537
—
LA
Enumeration date
11/29/2006
Last updated
06/17/2009
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