Individual
MS. CARLETTA STACKHOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ANP
Contact information
Practice address
40 LAWRENCE AVE, LYNBROOK, NY 11563-1830
(516) 253-0035
Mailing address
339 HEMPSTEAD AVENUE, PO BOX 328, MALVERNE, NY 11565-0328
(516) 253-0035
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
524609
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
307783
NY
Other
Enumeration date
03/28/2016
Last updated
07/14/2022
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