Healthcare Provider Details

I. General information

NPI: 1770083909
Provider Name (Legal Business Name): URSULA MAROSKI CARLISLE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2018
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 BARKSDALE BLVD
BOSSIER CITY LA
71112-3802
US

IV. Provider business mailing address

3330 BARKSDALE BLVD
BOSSIER CITY LA
71112-3802
US

V. Phone/Fax

Practice location:
  • Phone: 318-217-3330
  • Fax: 318-217-3331
Mailing address:
  • Phone: 318-217-3330
  • Fax: 318-217-3331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP09759
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: