Provider Demographics
NPI:1861692931
Name:CARLYLE, ANN MARIE (RNBS)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:CARLYLE
Suffix:
Gender:F
Credentials:RNBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 WRIGHTS LN
Mailing Address - Street 2:
Mailing Address - City:WEST NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10994-2913
Mailing Address - Country:US
Mailing Address - Phone:845-353-6799
Mailing Address - Fax:
Practice Address - Street 1:24 WRIGHTS LN
Practice Address - Street 2:
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-2913
Practice Address - Country:US
Practice Address - Phone:845-353-6799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY364297-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse