Healthcare Provider Details

I. General information

NPI: 1801220652
Provider Name (Legal Business Name): FUNKE ATKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2013
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 S WINOOSKI AVE
BURLINGTON VT
05401-7406
US

IV. Provider business mailing address

102 S WINOOSKI AVE
BURLINGTON VT
05401-7406
US

V. Phone/Fax

Practice location:
  • Phone: 802-488-6000
  • Fax: 802-488-6919
Mailing address:
  • Phone: 802-488-6920
  • Fax: 802-488-6919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number0250009135
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: