Provider Demographics
NPI:1063737104
Name:SAINT-FLEUR, KETTLY (RN)
Entity type:Individual
Prefix:
First Name:KETTLY
Middle Name:
Last Name:SAINT-FLEUR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 OAKDALE ST APT 35
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-8557
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:250 E MAIN ST UNIT 4B12
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:MA
Practice Address - Zip Code:02766-2436
Practice Address - Country:US
Practice Address - Phone:617-756-2182
Practice Address - Fax:508-310-0422
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY300693164X00000X
MA91254163W00000X
MALN91254164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No164X00000XNursing Service ProvidersLicensed Vocational Nurse
No163W00000XNursing Service ProvidersRegistered Nurse