Healthcare Provider Details

I. General information

NPI: 1215023635
Provider Name (Legal Business Name): PLANNED PARENTHOOD OF NORTHERN NEW ENGLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 11/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 LAKESIDE AVE STE 301
BURLINGTON VT
05401-4939
US

IV. Provider business mailing address

128 LAKESIDE AVE STE 301
BURLINGTON VT
05401-4939
US

V. Phone/Fax

Practice location:
  • Phone: 802-448-9784
  • Fax: 802-660-9435
Mailing address:
  • Phone: 802-448-9784
  • Fax: 802-660-9435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number042-0012729
License Number StateVT

VIII. Authorized Official

Name: HEATHER BUSHEY
Title or Position: CFO
Credential:
Phone: 802-448-9728