Healthcare Provider Details
I. General information
NPI: 1538723358
Provider Name (Legal Business Name): RACHEL BURNHAM APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/26/2019
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 LEDGEHILL RD
BENNINGTON VT
05201-5200
US
IV. Provider business mailing address
100 LEDGEHILL RD
BENNINGTON VT
05201-5200
US
V. Phone/Fax
- Phone: 802-442-5491
- Fax:
- Phone: 802-442-5491
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364SP0809X |
| Taxonomy | Adult Psychiatric/Mental Health Clinical Nurse Specialist |
| License Number | 101-0134312 |
| License Number State | VT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: