Healthcare Provider Details

I. General information

NPI: 1275843401
Provider Name (Legal Business Name): DORI E. WEIGAND MSN, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2010
Last Update Date: 05/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

168 BATTERY ST
BURLINGTON VT
05401-5285
US

IV. Provider business mailing address

168 BATTERY ST
BURLINGTON VT
05401-5285
US

V. Phone/Fax

Practice location:
  • Phone: 802-735-6895
  • Fax: 802-860-2399
Mailing address:
  • Phone: 802-735-6895
  • Fax: 802-860-2399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number0260018661
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: