Provider Demographics
NPI:1659636033
Name:KEBREAU, CAROLLE (NURSE PRACTITIONER,)
Entity Type:Individual
Prefix:MRS
First Name:CAROLLE
Middle Name:
Last Name:KEBREAU
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER,
Other - Prefix:
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Mailing Address - Street 1:760 BROADWAY, DEPARTMENT OF MANAGED CARE ROOM 2B-230
Mailing Address - Street 2:ATTN: CAROLLE KEBREAU, NP - WOODHULL HOSPITAL
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-1433
Mailing Address - Country:US
Mailing Address - Phone:718-486-2732
Mailing Address - Fax:718-630-3122
Practice Address - Street 1:760 BROADWAY - WOODHULL HOSPITAL CENTER
Practice Address - Street 2:MANAGED CARE DEPARTMENT ROOM 2B-230
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:718-486-2732
Practice Address - Fax:718-486-2732
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF3369701363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily