Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Colette Stakely

Individual provider Registered Nurse · NPI 1881173532

Colette Stakely is a Nurse Practitioner in Vestal, New York. Qualified in 2018, 8 years ago. Practices with Broome Family Nurse Practitioners PC, a 6-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
8
Licensed in
NY
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

4433 Vestal Pkwy E
Vestal, NY 13850
Phone: (607) 240-2879
Fax: (607) 240-2972
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 343553 (NY)
Registered Nurse Taxonomy 163W00000X · Licence 688402 (NY)

Record details

NPI number1881173532
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 13, 2018
Last updated in NPPESJanuary 9, 2025
Certification dateJanuary 9, 2025
Mailing address33 Lewis Rd, 2nd Fl, Binghamton, NY 13905

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Broome Family Nurse Practitioners Pc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Vestal