Provider Demographics
NPI:1932444213
Name:ST FLEUR, MARIE M (RN)
Entity Type:Individual
Prefix:MISS
First Name:MARIE
Middle Name:M
Last Name:ST FLEUR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:MARIE
Other - Middle Name:M
Other - Last Name:ST FLEUR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:13756 231ST ST
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-2831
Mailing Address - Country:US
Mailing Address - Phone:718-712-6205
Mailing Address - Fax:
Practice Address - Street 1:13756 231ST ST
Practice Address - Street 2:
Practice Address - City:LAURELTON
Practice Address - State:NY
Practice Address - Zip Code:11413-2831
Practice Address - Country:US
Practice Address - Phone:718-712-6205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY629085-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse