Healthcare Provider Details

I. General information

NPI: 1386548147
Provider Name (Legal Business Name): CRAIG A BABCOCK RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR
LEBANON NH
03756-1000
US

IV. Provider business mailing address

795 CENTER OF TOWN RD
WHITE RIVER JUNCTION VT
05001-9623
US

V. Phone/Fax

Practice location:
  • Phone: 603-650-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number092085-21
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: