Healthcare Provider Details

I. General information

NPI: 1104406776
Provider Name (Legal Business Name): COURTNEY LYNN BORLAND APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2021
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 BARRE MONTPELIER RD
BERLIN VT
05641
US

IV. Provider business mailing address

130 FISHER RD UNIT 1
BERLIN VT
05602-8132
US

V. Phone/Fax

Practice location:
  • Phone: 802-225-3970
  • Fax:
Mailing address:
  • Phone: 802-225-3970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2323643
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number101.0135526
License Number StateVT
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number067166-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: