Bourgeois, Kerstin L

Bourgeois, Kerstin L is an sole proprietor health care provider with primary practice located at 98 Paradise Rd , Central Square NY 13036-2253. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Bourgeois, Kerstin L can be contacted via phone (315) 668-2253.

Contact Information

Primary practice address
98 Paradise Rd Central Square NY 13036-2253
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 282586-1 New York

Profile Details

NPI number 1013044387
LBN Legal business name Bourgeois, Kerstin L
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 27th, 2007
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013044387 NPPES
New York MEDICAID 02749728

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