Healthcare Provider Details

I. General information

NPI: 1861433500
Provider Name (Legal Business Name): MAUREEN BOARDMAN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
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 8
NEWBURY VT
05051-0008
US

V. Phone/Fax

Practice location:
  • Phone: 802-222-9317
  • Fax: 888-462-0883
Mailing address:
  • Phone: 802-222-3026
  • Fax: 888-462-0883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0010030382
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: