Dr MARY A DAHLEN is a female medical professional, specializing in Nurse Practitioner. She graduated in 1996.
EXECUTIVE MEDICAL CLINIC OF LAKE CHARLES
2002 W WALNUT ST
SUITE 1A
LAKE CHARLES
LA
706015981
Tel: 3372101260
| Npi | 1235358003 |
| Pac Id | 7517068893 |
| Professional Enrollment Id | I20070731000377 |
| Last Name | DAHLEN |
| First Name | MARY |
| Middle Name | A |
| Suffix | |
| Gender | F |
| Credential | |
| Medical School Name | OTHER |
| Graduation Year | 1996 |
| Primary Specialty | NURSE PRACTITIONER |
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| Organization Legal Name | EXECUTIVE MEDICAL CLINIC OF LAKE CHARLES |
| Group Practice Pac Id | 8022341833 |
| Number Of Group Practice Members | 3 |
| Line 1 Street Address | 2002 W WALNUT ST |
| Line 2 Street Address | SUITE 1A |
| Marker Of Address Line 2 Suppression | |
| City | LAKE CHARLES |
| State | LA |
| Zip Code | 706015981 |
| Phone Number | 3372101260 |
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| Professional Accepts Medicare Assignment | Y |
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