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

MS. Katey Waldon, NP

Individual provider Registered Nurse · NPI 1487017901

MS. Katey Waldon, NP is a Nurse Practitioner in Fayetteville, New York. Graduated from State University of Ny Upstate Medical University in 2021, 5 years ago. Practices with Dr Fazeli and Dr Broumand LLC, an 11-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
5
Trained at
State University of Ny Upstate Medical University
Licensed in
NY
In the registry since
2016
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

4110 Medical Center Dr
Fayetteville, NY 13066-6613
Phone: (315) 663-0100
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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 347812 (NY)
Registered Nurse Taxonomy 163W00000X · Licence 707400 (NY)

Record details

NPI number1487017901
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorYes
NPI enumeratedApril 1, 2016
Last updated in NPPESMarch 15, 2023
Certification dateOctober 19, 2022
Mailing address4110 Medical Center Dr, Fayetteville, NY 13066-6613

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolSTATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduated 2021 (5 years in practice)
Group practice Dr. Fazeli And Dr. Broumand Llc — 11 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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