Provider Demographics
NPI:1508572561
Name:KERSEY, BABETTE RENEE
Entity Type:Individual
Prefix:
First Name:BABETTE
Middle Name:RENEE
Last Name:KERSEY
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 1:1305 DELMAR LOOP
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11239-1615
Mailing Address - Country:US
Mailing Address - Phone:347-598-9782
Mailing Address - Fax:
Practice Address - Street 1:1305 DELMAR LOOP
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11239-1615
Practice Address - Country:US
Practice Address - Phone:347-598-9782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344159164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse