Healthcare Provider Details

I. General information

NPI: 1447336763
Provider Name (Legal Business Name): JUNE MARIE BENOIT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

553 N MAIN ST PHWC
BARRE VT
05641-2501
US

IV. Provider business mailing address

16 HUBBARD PARK DR
MONTPELIER VT
05602-2138
US

V. Phone/Fax

Practice location:
  • Phone: 802-479-1229
  • Fax: 802-479-5444
Mailing address:
  • Phone: 802-223-6474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberVT 101-0010741
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: