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General NPI Number Information
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NPI Number | 1316605694
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Entity Type | Individual
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Provider Name | MRS. KATRINA ST.CLAIRE
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Gender | Female
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Dates
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Enumeration Date | 12/03/2021
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Last Update Date | 12/03/2021
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Provider Practice Location Address
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Address Line | 24524 HORACE HARDING EXPY
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City | LITTLE NECK
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State | NY
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Zip | 11362-2059
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Country | US
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Telephone | 269-218-0596
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Fax |
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Provider Business Mailing Address
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Address Line | 22 OAK POINT DR W
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City | BAYVILLE
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State | NY
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Zip | 11709-1112
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Country | US
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Telephone | 207-240-2919
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 348908
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License Number State | NY
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