MEDICARE: PASCALE C STEPHANI FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	4780074	UT
2	363LF0000X	Family Nurse Practitioner	101.0062975	VT
3	367A00000X	Advanced Practice Midwife	47800744402	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811935430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PASCALE C STEPHANI FNP

Provider Business Mailing Address
First Line	:	PO BOX 547
Second Line	:	CENTRAL VERMONT MEDICAL CENTER - FINANCE DEPT
City	:	BARRE
State	:	VT
Zip	:	05641-0547
Country	:	US
Telephone Number	:	802-225-5810
Fax Number	:	802-371-4821

Provider Business Practice Location Address
First Line	:	246 GRANGER RD
Second Line	:	SUITE 2
City	:	BERLIN
State	:	VT
Zip	:	05602-0000
Country	:	US
Telephone Number	:	802-225-5810
Fax Number	:	802-371-4821

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	12/11/2013

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