KATHLEEN MATTOON VANDERBROOK (NPI# 1255340782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255340782 |
| Entity Type | Individual |
| Full Name | KATHLEEN MATTOON VANDERBROOK |
| Credential | N.P. |
| Practice Address |
4 Coulter Rd Ste 1680 Clifton Springs NY 14432-1122 |
| Mailing Address |
601 Elmwood Ave Box 652 Rochester NY 14642-0001 |
| Practice Telephone | 3159064059 |
| Practice Fax Number | 3159064132 |
| Mailing Telephone | 5852757741 |
| Mailing Fax Number | 5852444320 |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-05-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
F300815 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01545275 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 165 E Union St Ste 327, Newark, NY 145131557 | 3153592661 | 3153316820 |
| 875 Pre Emption Rd, Geneva, NY 144562042 | 3157595320 | 3153503971 |
| 20 Hagen Dr Ste 120, Rochester, NY 146252666 | 5859225300 | 5859220450 |
| 601 Elmwood Ave, Box 652, Rochester, NY 146420001 | 5852757741 | 5852444320 |
| Street Address |
4 COULTER RD STE 1680 |
| City | CLIFTON SPRINGS |
| State | NY |
| Zip Code | 14432-1122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982035259 | David Roemer | Psychiatry & Neurology | 28 E Main Street, Clifton Springs, NY 14432 | 2013-12-11 |
| 1477821122 | Margaret Lewis Carlson | Registered Nurse | 1510 Rt 488, Clifton Springs, NY 14432 | 2011-12-09 |
| 1063698769 | Debra J Gates | Nurse Practitioner | Rrhs Clifton Springs Hospital and Clinic - Endocrine, 2 Coulter Rd, Clifton Springs, NY 14432 | 2008-01-14 |
| 1154457042 | Elaine M. Allen | Massage Therapist | 31 Pleasant Street, Clifton Springs, NY 14432 | 2007-02-26 |
| 1568514271 | Tracy Ford | Physical Therapist | 440 Clifton Springs Professional Park, Clifton Springs, NY 14432 | 2007-01-16 |
| 1265482400 | Lynn M Sievert | Internal Medicine | 6 Ambulance Drive, Clifton Springs, NY 14432 | 2006-05-10 |
| 1376531590 | Ileana Hernandez | Internal Medicine | 2 Coulter Rd, Clifton Springs, NY 14432 | 2005-10-11 |
| 1366434011 | Finger Lakes Area Counseling and Recovery Agency, Inc. | Clinic/Center | 28 E Main St, Clifton Springs, NY 14432 | 2005-08-18 |
| 1104483858 | Mara Elizabeth Schroeder | Physician Assistant | 2 Coulter Rd, Clifton Springs, NY 14432 | 2019-05-28 |
| 1972024602 | Andrea L Nichols | Specialist/Technologist, Other | 210 Clifton Springs Professional Park, Clifton Springs, NY 14432 | 2017-07-03 |
| Find all providers in zip 14432 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205355229 | Margaret Socha | Nurse Practitioner | 2 Coulter Rd Ste 1620, Clifton Springs, NY 14432-1122 | 2017-09-11 |
| 1063698769 | Debra J Gates | Nurse Practitioner | Rrhs Clifton Springs Hospital and Clinic - Endocrine, 2 Coulter Rd, Clifton Springs, NY 14432 | 2008-01-14 |
| 1629587027 | Jessica Randall | Nurse Practitioner | 2 Coulter Rd, Clifton Springs, NY 14432-1122 | 2017-09-28 |
| 1144262379 | Kimberly Moore Wesley | Nurse Practitioner | 2 Coulter Rd, Clifton Springs, NY 14432-1122 | 2006-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427871 | Tammie Kae Copp | Nurse Practitioner | 8266 Casson Rd, Lindley, NY 14858-9697 | 2020-11-08 |
| 1770184673 | Annette Virosami | Nurse Practitioner | 890 Trinity Ave Apt 8d, Bronx, NY 10456-7419 | 2020-11-06 |
| 1972104958 | Jonathan Dillera Nietes | Nurse Practitioner | 4411 Macnish St Apt 1g, Elmhurst, NY 11373-3609 | 2020-11-05 |
| 1407457088 | Sanjana Kumari | Nurse Practitioner | 62 Albertson Pl, Mineola, NY 11501-4601 | 2020-11-02 |
| 1780284927 | Hannah Catan | Nurse Practitioner | 473 W 158th St Apt 10, New York, NY 10032-5361 | 2020-10-27 |
| 1700486248 | Amandeep Kaur | Nurse Practitioner | 7638 270th St, New Hyde Park, NY 11040-1418 | 2020-10-26 |
| 1861091324 | Stacey M Jantsch | Nurse Practitioner | 8237 Cicero Mills Rd, Cicero, NY 13039-8344 | 2020-10-25 |
| 1871192468 | Adult Health Np House Calls, PC | Nurse Practitioner | 7954 Transit Rd # 134, Williamsville, NY 14221-4117 | 2020-10-23 |
| 1104425891 | Tze-hsuan Chao | Nurse Practitioner | 3916 Prince St Ste 257, Flushing, NY 11354-5367 | 2020-10-22 |
| 1992304968 | Nicholas Robinson | Nurse Practitioner | 295 Essjay, Williamsville, NY 14221 | 2020-10-21 |
| Find all providers with the same taxonomy | ||||
| City | CLIFTON SPRINGS |
| Zip Code | 14432 |
Please comment or provide details below to improve the information on KATHLEEN MATTOON VANDERBROOK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.