Healthcare Provider Details

I. General information

NPI: 1669593125
Provider Name (Legal Business Name): ANDREA VAN BUREN REGAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 FERRY RD
CHARLOTTE VT
05445-9555
US

IV. Provider business mailing address

PO BOX 38
CHARLOTTE VT
05445-0038
US

V. Phone/Fax

Practice location:
  • Phone: 802-425-2781
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number38108
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0420011445
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: