Provider Demographics
NPI:1720588106
Name:GUILLAUME, CARRIAN (RN)
Entity Type:Individual
Prefix:
First Name:CARRIAN
Middle Name:
Last Name:GUILLAUME
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 20TH ST STE 4C&4D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-1180
Mailing Address - Country:US
Mailing Address - Phone:718-431-2875
Mailing Address - Fax:718-431-8709
Practice Address - Street 1:164 20TH ST STE 4C&4D
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-1180
Practice Address - Country:US
Practice Address - Phone:718-431-2875
Practice Address - Fax:718-431-8709
Is Sole Proprietor?:No
Enumeration Date:2018-02-13
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY542307-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse