Healthcare Provider Details

I. General information

NPI: 1609731801
Provider Name (Legal Business Name): NATALIE ANN NIMON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 PORTER DR
MIDDLEBURY VT
05753-8629
US

IV. Provider business mailing address

152 ALLEN RD UNIT 243
SOUTH BURLINGTON VT
05403-3807
US

V. Phone/Fax

Practice location:
  • Phone: 802-388-4701
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number026.0140394
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: