Provider Demographics
NPI:1417848797
Name:MCLIN, DUSTIN (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:DUSTIN
Middle Name:
Last Name:MCLIN
Suffix:
Gender:M
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32170 KEILA DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:LA
Mailing Address - Zip Code:70462-7501
Mailing Address - Country:US
Mailing Address - Phone:225-362-6264
Mailing Address - Fax:
Practice Address - Street 1:29565 S FROST RD STE C
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:LA
Practice Address - Zip Code:70754-1903
Practice Address - Country:US
Practice Address - Phone:225-686-1114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA205974363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily