Healthcare Provider Details

I. General information

NPI: 1588306062
Provider Name (Legal Business Name): BRIANNA L HOAR APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 04/13/2022
Certification Date: 04/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 ALLEN ST
RUTLAND VT
05701-4560
US

IV. Provider business mailing address

160 ALLEN ST
RUTLAND VT
05701-4560
US

V. Phone/Fax

Practice location:
  • Phone: 802-772-1900
  • Fax: 802-772-2556
Mailing address:
  • Phone: 802-772-1900
  • Fax: 802-772-2556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number101.0135009
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: