Healthcare Provider Details

I. General information

NPI: 1780787630
Provider Name (Legal Business Name): CYNTHIA MARQUESS STADLER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYNTHIA JANE MARQUESS CNM

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 03/04/2020
Certification Date: 03/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 MAIN ST
NORWICH VT
05055-4428
US

IV. Provider business mailing address

PO BOX 1590
NORWICH VT
05055-1590
US

V. Phone/Fax

Practice location:
  • Phone: 802-526-2380
  • Fax: 802-256-2518
Mailing address:
  • Phone: 802-526-2380
  • Fax: 802-526-2518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number045223-23-01
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: