Provider Demographics
NPI:1306303243
Name:LOUIS-PAUL, MARIE NIRVA (FNP)
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:NIRVA
Last Name:LOUIS-PAUL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CONRAD LN
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-6851
Mailing Address - Country:US
Mailing Address - Phone:845-826-3118
Mailing Address - Fax:
Practice Address - Street 1:4 CONRAD LN
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-6851
Practice Address - Country:US
Practice Address - Phone:845-826-3118
Practice Address - Fax:845-826-3118
Is Sole Proprietor?:No
Enumeration Date:2019-02-27
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY568006163WM0705X
NYF340353-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical