Healthcare Provider Details

I. General information

NPI: 1609897743
Provider Name (Legal Business Name): CHERYL A HOLTON N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 01/29/2020
Certification Date: 01/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 PROFESSIONAL DR
MORRISVILLE VT
05661-9301
US

IV. Provider business mailing address

109 PROFESSIONAL DR
MORRISVILLE VT
05661-9301
US

V. Phone/Fax

Practice location:
  • Phone: 802-851-0999
  • Fax:
Mailing address:
  • Phone: 802-851-0999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number101-0011324
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number101-0011324
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: