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Organization
KLE NURSE PRACTITIONER IN PSYCHIATRY PLLC
Active
Organization
KLE NURSE PRACTITIONER IN PSYCHIATRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEMISOLA EBIETOMIYE (OWNER OF ENTITY)
(347) 378-3144
Entity
Organization
Contact information
Practice address
109 N 12TH ST STE 704, BROOKLYN, NY 11249-1002
(347) 378-3144
(469) 242-9827
Mailing address
548 WESTWOOD WAY DR, HASLET, TX 76052-3079
(347) 378-3144
(469) 242-9827
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/24/2024
Last updated
05/14/2025
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