Healthcare Provider Details

I. General information

NPI: 1093951667
Provider Name (Legal Business Name): MARGARET ANNE BURDEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/01/2009
Last Update Date: 01/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1122 WILD HILL RD
FAIRLEE VT
05045-9526
US

IV. Provider business mailing address

1122 WILD HILL RD
FAIRLEE VT
05045-9526
US

V. Phone/Fax

Practice location:
  • Phone: 802-333-4334
  • Fax:
Mailing address:
  • Phone: 802-333-4334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number026-0029951
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: