National Provider Identifier

Brooke Jayme Kaczcoughnett, NP

Brooke Jayme Kaczcoughnett, NP is listed in the NPPES registry with a primary specialty of Adult Health Nurse Practitioner in Cheektowaga, NY and a listed phone number of (315) 783-3115.

NPI 1114774809Cheektowaga, NYAdult Health Nurse Practitioner

Profile Overview

NPI
1114774809
Provider Type
Individual
Primary Specialty
Adult Health Nurse Practitioner
Enumeration Date
May 01, 2024
Last Updated
May 01, 2024

Practice Location

  • 14 Ravenswood Ter
  • Cheektowaga, NY 14225-1145

Phone: (315) 783-3115

Specialties

  • Adult Health Nurse Practitioner (363LA2200X)
Full Record
NPI
1114774809
Entity Type
Individual
Last Name
Kaczcoughnett
First Name
Brooke
Middle Name
Jayme
Credential
NP
Provider Other Last Name
Vancoughnett
Provider Other First Name
Brooke
Provider Other Middle Name
Jayme
Provider Other Credential Text
NP
Provider Other Last Name Type Code
1
Mailing Street Address
14 Ravenswood Ter
Mailing City
Cheektowaga
Mailing State
NY
Mailing ZIP Code
14225-1145
Mailing Country
US
Mailing Phone
(315) 783-3115
Practice Street Address
14 Ravenswood Ter
Practice City
Cheektowaga
Practice State
NY
Practice ZIP Code
14225-1145
Practice Country
US
Practice Phone
(315) 783-3115
Enumeration Date
May 01, 2024
Last Updated
May 01, 2024
Sex
Female
Sole Proprietor
No
Certification Date
May 01, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Adult Health Nurse Practitioner (363LA2200X)