Provider Demographics
NPI:1912465196
Name:DESRAMEAUX, SHIRLEY (RN)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:
Last Name:DESRAMEAUX
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 1:45 MARTENSE ST APT 1K
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-3271
Mailing Address - Country:US
Mailing Address - Phone:347-500-9625
Mailing Address - Fax:
Practice Address - Street 1:45 MARTENSE ST APT 1K
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-3271
Practice Address - Country:US
Practice Address - Phone:347-500-9625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7432521163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse