Provider Demographics
NPI:1164802278
Name:PAULEUS, KATHLEEN (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:
Last Name:PAULEUS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MISS
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:FRANCOIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:8314 AVENUE K
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-4234
Mailing Address - Country:US
Mailing Address - Phone:347-337-9553
Mailing Address - Fax:
Practice Address - Street 1:8314 AVENUE K
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-4234
Practice Address - Country:US
Practice Address - Phone:347-337-9553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-03
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY347634363LF0000X
NY699445-1163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice