Healthcare Provider Details

I. General information

NPI: 1831766047
Provider Name (Legal Business Name): KATHIE BROOKE PROPER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHIE BROOKE PURCELL NP

II. Dates (important events)

Enumeration Date: 06/07/2021
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 FITCH ST STE 102
ELMIRA NY
14905-1634
US

IV. Provider business mailing address

600 IVY ST STE 206
ELMIRA NY
14905-1627
US

V. Phone/Fax

Practice location:
  • Phone: 607-734-6544
  • Fax: 607-734-6580
Mailing address:
  • Phone: 607-271-2050
  • Fax: 607-271-2071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number347767
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: