Healthcare Provider Details

I. General information

NPI: 1184548844
Provider Name (Legal Business Name): LOUISE BERNADETTE MONGEON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 ARCHIBALD ST
BURLINGTON VT
05401-4220
US

IV. Provider business mailing address

6 ARCHIBALD ST
BURLINGTON VT
05401-4220
US

V. Phone/Fax

Practice location:
  • Phone: 802-865-4172
  • Fax: 802-419-9124
Mailing address:
  • Phone: 802-865-4172
  • Fax: 802-419-9124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number026.0013232
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: