Healthcare Provider Details

I. General information

NPI: 1841391216
Provider Name (Legal Business Name): FULL CIRCLE WOMEN'S HEALTH, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 SOUTH WINDSOR ST
SOUTH ROYALTON VT
05068
US

IV. Provider business mailing address

PO BOX 119 79 SOUTH WINDSOR ST
SOUTH ROYALTON VT
05068-0119
US

V. Phone/Fax

Practice location:
  • Phone: 802-763-7713
  • Fax:
Mailing address:
  • Phone: 802-763-7713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA STADLER
Title or Position: CO-OWNER
Credential: CNM
Phone: 802-763-7713