Provider Demographics
NPI:1588705164
Name:BRAKMAN, PATRICIA SULLIVAN (NP)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:SULLIVAN
Last Name:BRAKMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 NOXON ST
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-4101
Mailing Address - Country:US
Mailing Address - Phone:845-471-1540
Mailing Address - Fax:
Practice Address - Street 1:17 NOXON ST
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-4101
Practice Address - Country:US
Practice Address - Phone:845-471-1540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY420984363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health