Healthcare Provider Details

I. General information

NPI: 1043758634
Provider Name (Legal Business Name): KARINE ERAMILE REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2017
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4560 KEENELAND LN UNIT 104
FORT WAYNE IN
46845-1996
US

IV. Provider business mailing address

4560 KEENELAND LN UNIT 104
FORT WAYNE IN
46845-1996
US

V. Phone/Fax

Practice location:
  • Phone: 917-573-3508
  • Fax: 917-573-3508
Mailing address:
  • Phone: 917-573-3508
  • Fax: 917-573-3508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number26NR17449800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number508146-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: