Healthcare Provider Details

I. General information

NPI: 1740681642
Provider Name (Legal Business Name): SABINE WATSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SABINE JULES

II. Dates (important events)

Enumeration Date: 09/10/2014
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 MEMORIAL DR
ST JOHNSBURY VT
05819-8321
US

IV. Provider business mailing address

964 MOULTHROP RD
EAST HAVEN VT
05837-9811
US

V. Phone/Fax

Practice location:
  • Phone: 802-318-4768
  • Fax: 802-424-1163
Mailing address:
  • Phone: 802-363-3209
  • Fax: 802-748-4540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number101.0106507
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number1010106507
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: