MEDICARE: DUSTIN TYLER STRICKLAND NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	A005286	AR
2	363LF0000X	Family Nurse Practitioner	AP09398	LA

General Provider Information

NPI Number	:	1235653692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DUSTIN TYLER STRICKLAND NP-C

Provider Business Mailing Address
First Line	:	706 ROSS ST
Second Line	:
City	:	OAK GROVE
State	:	LA
Zip	:	71263-9798
Country	:	US
Telephone Number	:	318-428-3237
Fax Number	:

Provider Business Practice Location Address
First Line	:	502 ROSS ST
Second Line	:
City	:	OAK GROVE
State	:	LA
Zip	:	71263-9706
Country	:	US
Telephone Number	:	318-428-2358
Fax Number	:	318-428-2350

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2017
Last Update Date	:	03/30/2023

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