Healthcare Provider Details

I. General information

NPI: 1932583481
Provider Name (Legal Business Name): TANIA THOMAS CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2015
Last Update Date: 12/09/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 FARRELL ST
SOUTH BURLINGTON VT
05403-6113
US

IV. Provider business mailing address

2948 COUNTY RD
MONTPELIER VT
05602-8652
US

V. Phone/Fax

Practice location:
  • Phone: 802-864-9940
  • Fax:
Mailing address:
  • Phone: 802-595-9495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: