Individual
JEANINE MICHELLE CARNIVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RN, AGNP-C, CCRN
Contact information
Practice address
101 NICHOLLS ROAD STONY BROOK HOSPITA, STONY BROOK, NY 11794-0001
(631) 444-1665
Mailing address
101 NICHOLLS ROAD STONY BROOK HOSPITA, STONY BROOK, NY 11794-0001
(631) 444-1665
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F308885
NY
Other
Enumeration date
08/07/2019
Last updated
08/07/2019
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