Healthcare Provider Details

I. General information

NPI: 1255504619
Provider Name (Legal Business Name): KATHERINE M BRAMHALL LMVT, NHCM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2008
Last Update Date: 04/28/2020
Certification Date: 04/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 COLBY ST
BARRE VT
05641-2705
US

IV. Provider business mailing address

25 COLBY ST
BARRE VT
05641-2705
US

V. Phone/Fax

Practice location:
  • Phone: 802-279-3158
  • Fax: 802-448-6880
Mailing address:
  • Phone: 802-279-3158
  • Fax: 802-479-9050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1042
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number107-0000044
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: