Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dustin David Denicola, NP

Individual provider Adult Health Nurse Practitioner · NPI 1073879508

Dustin David Denicola, NP is a Nurse Practitioner in Baton Rouge, Louisiana. Qualified in 2010, 16 years ago. Practices with Our Lady of the Lake Physician Group LLC, a 635-clinician group and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
16
Licensed in
LA
In the registry since
2012
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

4950 Essen Ln Ste 300
Baton Rouge, LA 70809-3738
Phone: (225) 490-8882
Fax: (225) 765-9085
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence RN117110-AP06574 (LA)

Record details

NPI number1073879508
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedApril 10, 2012
Last updated in NPPESMarch 23, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Our Lady Of The Lake Physician Group Llc — 635 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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