Healthcare Provider Details

I. General information

NPI: 1386728079
Provider Name (Legal Business Name): MRS. LAURA A. BARBER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

437 S MAIN ST
BRADFORD VT
05033-9196
US

IV. Provider business mailing address

PO BOX 318
BRADFORD VT
05033-0318
US

V. Phone/Fax

Practice location:
  • Phone: 802-222-9317
  • Fax: 888-462-0883
Mailing address:
  • Phone: 802-222-9317
  • Fax: 888-462-0883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG5641
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number042.0013167
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: