Provider Demographics
NPI:1558052142
Name:NERELUS, MARIE CARINE
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:CARINE
Last Name:NERELUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:C
Other - Last Name:THALERAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1261 NW 49TH ST
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-1034
Mailing Address - Country:US
Mailing Address - Phone:239-738-9990
Mailing Address - Fax:
Practice Address - Street 1:654 PARK LAKE ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-3906
Practice Address - Country:US
Practice Address - Phone:407-921-0627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL202303046374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula