Loustalot, Fleetwood
Loustalot, Fleetwood is an individual health care provider with primary practice located at 2 Lakeview Cv , Hattiesburg MS 39402-8528. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Loustalot, Fleetwood can be contacted via phone (601) 264-2657.Contact Information
Primary practice address
2 Lakeview Cv
Hattiesburg MS 39402-8528
Phone: (601) 264-2657
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R864143 | Mississippi |
Profile Details
| NPI number | 1164470928 |
|---|---|
| LBN Legal business name | Loustalot, Fleetwood |
| Credentials | RN, NP-C, PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 4th, 2006 |
| Last updated | Jan 5th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164470928 | NPPES |
| Mississippi | MEDICAID | 0126734 | |
| Mississippi | Other | R864143 |
Popular Providers
-
Bartran, Lori H.
6414 U S Highway 98 , Hattiesburg MS 39402-7815 -
Harris, Rachel R
222 S 27Th Ave , Hattiesburg MS 39401-7165 -
Scrape, Sara J.
9 Willow Bend Dr , Hattiesburg MS 39402-8552 -
Lee, Lyndell Sue
6051 Highway 49 , Hattiesburg MS 39401-7200 -
Tomlinson, Donna Dimarco
1 Lincoln Pkwy Ste 202 , Hattiesburg MS 39402-3261 -
Guszick, Louise Marie
1302 Lee Ave Camp Shelby Medical Soldiers Readiness Processing Cente, Hattiesburg MS 39401 -
Delancey, Melinda Bennett
6766 U S Highway 98 , Hattiesburg MS 39402-8443 -
Clearman, Selena
7100 U S Highway 98 Ste 140 , Hattiesburg MS 39402