Provider Demographics
NPI:1548594013
Name:VOIGT, BREANNA NICOLE (RPA-C)
Entity Type:Individual
Prefix:
First Name:BREANNA
Middle Name:NICOLE
Last Name:VOIGT
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3670 S BENZING RD
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1705
Mailing Address - Country:US
Mailing Address - Phone:716-662-5357
Mailing Address - Fax:716-662-2774
Practice Address - Street 1:3680 EGGERT RD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1963
Practice Address - Country:US
Practice Address - Phone:716-662-5357
Practice Address - Fax:716-662-2774
Is Sole Proprietor?:No
Enumeration Date:2009-09-30
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013597363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant