Healthcare Provider Details

I. General information

NPI: 1902909922
Provider Name (Legal Business Name): CHRISTIE JUDD ALDRICH FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 04/30/2021
Certification Date: 04/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

488 ELM ST
BARTON VT
05822-8637
US

IV. Provider business mailing address

193 ALDRICH LN
ORLEANS VT
05860-9321
US

V. Phone/Fax

Practice location:
  • Phone: 802-525-3539
  • Fax:
Mailing address:
  • Phone: 802-754-2336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number101-0013882
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: