Healthcare Provider Details
I. General information
NPI: 1881510006
Provider Name (Legal Business Name): BROOKE LINDSEY BILLADO RN, MSN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/24/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
775 HUNTER RD
JOHNSON VT
05656-9392
US
IV. Provider business mailing address
775 HUNTER RD
JOHNSON VT
05656-9392
US
V. Phone/Fax
- Phone: 802-793-4319
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 101.0139557 |
| License Number State | VT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: