Provider Demographics
NPI:1063886620
Name:FEKETE-BRUNNER, NICOLE CATHERINE (APRN BC FNP)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:CATHERINE
Last Name:FEKETE-BRUNNER
Suffix:
Gender:F
Credentials:APRN BC FNP
Other - Prefix:MISS
Other - First Name:NICOLE
Other - Middle Name:CATHERINE
Other - Last Name:FEKETE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN BC FNP
Mailing Address - Street 1:4850 EOFF ST
Mailing Address - Street 2:
Mailing Address - City:BENWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26031-1008
Mailing Address - Country:US
Mailing Address - Phone:304-233-1656
Mailing Address - Fax:304-234-6749
Practice Address - Street 1:302 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:ST. CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950
Practice Address - Country:US
Practice Address - Phone:740-968-7006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-19
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH18414363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily