Individual provider · Type 1 NPI
Modise Elmine-Dautruche, MSN, NP
Adult Health Nurse Practitioner · Brooklyn, NY
NPI number
1316620214
Active
Practice location
541 Clarkson Ave
Brooklyn, NY 11203
Fax (718) 245-5587
Mailing address
900 Franklin Ave
Valley Stream, NY 11580-2145
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 543061-1 (NY) |
| Adult Health Nurse Practitioner Primary | 363LA2200X | 31176801 (NY) |
Adult Health Nurse Practitioner: Definition to come...
3 other providers at this address
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About NPI 1316620214
Modise Elmine-Dautruche, MSN, NP's National Provider Identifier is 1316620214, issued on Aug 8, 2023. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Brooklyn, NY. The record was last updated on Aug 13, 2025.