Healthcare Provider Details

I. General information

NPI: 1518101005
Provider Name (Legal Business Name): CAROL M COMAR FROST NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2009
Last Update Date: 04/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

339 DEWEY ST
BENNINGTON VT
05201-2253
US

IV. Provider business mailing address

100 HOSPITAL DR
BENNINGTON VT
05201-5004
US

V. Phone/Fax

Practice location:
  • Phone: 802-442-8164
  • Fax:
Mailing address:
  • Phone: 802-442-6261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1010048068
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: