Healthcare Provider Details

I. General information

NPI: 1053796144
Provider Name (Legal Business Name): EMILY JOSEPHINE ALFANO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2015
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 FISHER RD UNIT 1
BERLIN VT
05602-8132
US

IV. Provider business mailing address

4093 COUNTY RD
MONTPELIER VT
05602-8627
US

V. Phone/Fax

Practice location:
  • Phone: 802-225-3980
  • Fax:
Mailing address:
  • Phone: 202-557-9348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number101.0121620
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number6170
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: