Provider Demographics
NPI:1053703652
Name:ST PIERRE, NADINE
Entity type:Individual
Prefix:
First Name:NADINE
Middle Name:
Last Name:ST PIERRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 ALBEMARLE RD
Mailing Address - Street 2:APT 4P
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-3988
Mailing Address - Country:US
Mailing Address - Phone:347-254-2037
Mailing Address - Fax:
Practice Address - Street 1:2111 ALBEMARLE RD
Practice Address - Street 2:APT 4P
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-3988
Practice Address - Country:US
Practice Address - Phone:347-254-2037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-19
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY320826-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse