Jacqueline Joyce Brabant, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Canton, NY
NPI 1417028341 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1417028341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 019238 (IL)
- Practice address
- 166 Plains Rd
Canton, NY 13617-3291 - Phone
- (315) 386-1228
- NPI assigned
- Nov 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 327469-1 | NY | MD | Registered Nurse |
| 019238 | IL | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allan Jacobs MD PD | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 327469-1 | NY | |
| Certified Registered Nurse Anesthetist | 367500000X | 019238 | IL | Yes |
Addresses
Primary practice location
166 Plains Rd
Canton, NY 13617-3291
Mailing address
166 Plains Rd
Canton, NY 13617-3291
Phone (315) 386-1228
Other providers in Canton, NY
- Andrea Anne Bonno
- Anne Elizabeth Bonno
- Kaileigh Bonno
- Jennifer K Bourdette
- Brian Eric Boutilier
- Dawn Lee Brabaw
- Haley Ann Brandes
- Kiri Pryjma Brandy
- Danielle C. Brining-Plumadore
- Susan E Britton
All providers in Canton, NY · Certified Registered Nurse Anesthetist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.