Individual
CAROLE JEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1530 PENNSYLVANIA AVE APT 5C, BROOKLYN, NY 11239-2607
(347) 938-5876
Mailing address
1530 PENNSYLVANIA AVE APT 5C, BROOKLYN, NY 11239-2607
(347) 938-5876
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
337465
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
337465
LICENSE
NY
Enumeration date
05/04/2020
Last updated
05/04/2020
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