Individual
KETLIE CAMILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
787 E 46TH ST, APT 5D, BROOKLYN, NY 11203-5751
(718) 629-5467
Mailing address
787 E 46TH ST APT 5D, BROOKLYN, NY 11203-5751
(718) 629-5467
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
55918701
NY
Other
Enumeration date
06/16/2022
Last updated
06/16/2022
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