Basic Information
| Provider Information | |||||||||
| NPI: | 1659636033 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KEBREAU | ||||||||
| FirstName: | CAROLLE | ||||||||
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| NamePrefix: | MRS. | ||||||||
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| Credential: | NURSE PRACTITIONER, | ||||||||
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| Mailing Information | |||||||||
| Address1: | 760 BROADWAY, DEPARTMENT OF MANAGED CARE ROOM 2B-230 | ||||||||
| Address2: | ATTN: CAROLLE KEBREAU, NP - WOODHULL HOSPITAL | ||||||||
| City: | WEST HEMPSTEAD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115521433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184862732 | ||||||||
| FaxNumber: | 7186303122 | ||||||||
| Practice Location | |||||||||
| Address1: | 760 BROADWAY - WOODHULL HOSPITAL CENTER | ||||||||
| Address2: | MANAGED CARE DEPARTMENT ROOM 2B-230 | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184862732 | ||||||||
| FaxNumber: | 7184862732 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2012 | ||||||||
| LastUpdateDate: | 04/08/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | F3369701 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.