Nicole D Bracken, RN

Primary specialty

Pediatric Registered NurseTaxonomy code 163WP0200X

License

770845 Issued in NY

Practice address

29 Stagecoach TRL
Middletown, NY 10940-7089

Phone

(845) 239-6638

NPI assigned

May 4, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1831458330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 STAGECOACH TRL",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109407089",
            "telephone_number": "845-239-6638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 STAGECOACH TRL",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109407089",
            "telephone_number": "845-239-6638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "312 Tower Ave",
            "address_2": "Apartment 3",
            "address_purpose": "LOCATION",
            "city": "Maybrook",
            "state": "NY",
            "postal_code": "125431527",
            "country_code": "US",
            "telephone_number": "845-239-6638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRACKEN",
        "first_name": "NICOLE",
        "middle_name": "D",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-04",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NY",
            "license": "770845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ann Bowe, PSYD
• Kaitlin Bowe, FNP
• Kerryann Bowlin
• Andrea Bracciante Ely, MS SP, CCC-SLP
• Grace Brack, COTA
• Erin Michelle Bradley-Petersen, LCSW
• Benjamin Bradley, PA-C
• Anthony Joseph Bradt, O.D.
• Ann Brady, NP
• Lauren Lynn Brady

• Pediatric Registered Nurse in Middletown, NY
• Providers in Middletown, NY by specialty
• Pediatric Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.