Provider Demographics
NPI:1346801206
Name:BROOME FAMILY NURSE PRACTITIONERS PC
Entity Type:Organization
Organization Name:BROOME FAMILY NURSE PRACTITIONERS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-306-7546
Mailing Address - Street 1:2220 VESTAL PKWY E FL 2
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-1947
Mailing Address - Country:US
Mailing Address - Phone:607-306-7546
Mailing Address - Fax:607-821-7848
Practice Address - Street 1:2220 VESTAL PKWY E FL 2
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-1947
Practice Address - Country:US
Practice Address - Phone:607-306-7546
Practice Address - Fax:607-821-7848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-21
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty