Healthcare Provider Details

I. General information

NPI: 1013765510
Provider Name (Legal Business Name): CHELSEA EMMA CURTIS RD, CD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2024
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

790 COLLEGE PKWY
COLCHESTER VT
05446-3007
US

IV. Provider business mailing address

78 SANDHILL RD APT 27
ESSEX JUNCTION VT
05452-3953
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-3640
  • Fax:
Mailing address:
  • Phone: 802-999-5614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number074.0134226
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: