Provider Demographics
NPI:1265733893
Name:PIERRE, KATUUSKA ANDRE (LPN)
Entity type:Individual
Prefix:MISS
First Name:KATUUSKA
Middle Name:ANDRE
Last Name:PIERRE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16844 127TH AVE APT 13G
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-3158
Mailing Address - Country:US
Mailing Address - Phone:718-810-5082
Mailing Address - Fax:
Practice Address - Street 1:16844 127TH AVE APT 13G
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-3158
Practice Address - Country:US
Practice Address - Phone:718-810-5082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-12
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2971331164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse