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

Individual provider Physician Assistant · NPI 1568179380

Nicollette Brianne Oudkerk, PA is a Physician Assistant in New York, New York. Practices as a sole proprietor and works from 2 locations. Licensed in New York.

Licensed in
NY
In the registry since
2022
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

419 W 114th St
New York, NY 10025-1710
Phone: (212) 523-4000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1000 10th Ave, New York, NY 10019-1147 — (212) 523-4000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 029045-01 (NY)

Record details

NPI number1568179380
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedNovember 1, 2022
Last updated in NPPESNovember 1, 2022
Certification dateNovember 1, 2022

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