Healthcare Provider Details

I. General information

NPI: 1265785174
Provider Name (Legal Business Name): HEATHER MARIE KIERSTEAD CNM, WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER FERREIRA

II. Dates (important events)

Enumeration Date: 10/17/2012
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 BELMONT AVE
BRATTLEBORO VT
05301-7110
US

IV. Provider business mailing address

600 BLAIR PARK RD STE 285
WILLISTON VT
05495-7855
US

V. Phone/Fax

Practice location:
  • Phone: 802-258-3905
  • Fax: 802-258-4903
Mailing address:
  • Phone: 802-288-1140
  • Fax: 802-288-1144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number101.0098996
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number078857-23
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number101.0098996
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: