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NPI Code Detail

MEDICARE: CARISSA LEIGH STROUSE APRN

MEDICARE: CARISSA LEIGH STROUSE APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN9270473FL
2163WG0000XGeneral Practice Registered Nurse599181NY
3363LA2200XAdult Health Nurse Practitioner11002979FL

General Provider Information

NPI Number : 1124377270
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARISSA LEIGH STROUSE APRN
Provider Business Mailing Address
First Line : 7404 5TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-2704
Country : US
Telephone Number : 718-439-5111
Fax Number :
Provider Business Practice Location Address
First Line : 7404 5TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-2704
Country : US
Telephone Number : 718-439-5111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2012
Last Update Date : 04/27/2020

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