Healthcare Provider Details

I. General information

NPI: 1134840184
Provider Name (Legal Business Name): BRITTANY M KILIANSKI FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2022
Last Update Date: 09/08/2022
Certification Date: 09/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3980 SHERIDAN DR
BUFFALO NY
14226-1727
US

IV. Provider business mailing address

5260 ROGERS RD APT E8
HAMBURG NY
14075-3587
US

V. Phone/Fax

Practice location:
  • Phone: 716-699-9032
  • Fax: 716-699-9035
Mailing address:
  • Phone: 716-213-7481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number350236
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: