Healthcare Provider Details

I. General information

NPI: 1861357071
Provider Name (Legal Business Name): ADDISON NORTHWEST SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 MAIN STREET SUITE B100
VERGENNES VT
05491
US

IV. Provider business mailing address

11 MAIN STREET SUITE B100
VERGENNES VT
05491
US

V. Phone/Fax

Practice location:
  • Phone: 802-877-3332
  • Fax: 802-877-3626
Mailing address:
  • Phone: 802-877-3332
  • Fax: 802-877-3626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: LAURA R NUGENT
Title or Position: ASSISTANT SUPERINTENDENT F STUDENT
Credential: ED.D.
Phone: 802-870-8913