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General NPI Number Information
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NPI Number | 1326024894
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Entity Type | Individual
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Provider Name | TAMMY LEIGH AUSTIN-KETCH NP
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Gender | Female
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Dates
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Enumeration Date | 12/16/2005
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Last Update Date | 10/22/2008
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Provider Practice Location Address
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Address Line | 3003 9TH ST
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City | NIAGARA FALLS
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State | NY
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Zip | 14305-1931
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Country | US
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Telephone | 716-284-8917
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Fax | 716-284-0428
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Provider Business Mailing Address
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Address Line | 3596 CURTISS AVE PO BOX 59
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City | RANSOMVILLE
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State | NY
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Zip | 14131-0059
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Country | US
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Telephone | 716-870-4668
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Fax | 716-829-2067
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F331418
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License Number State | NY
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