Healthcare Provider Details

I. General information

NPI: 1437309564
Provider Name (Legal Business Name): HEATHER BROWN KIDDE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. HEATHER LAUREN BROWN

II. Dates (important events)

Enumeration Date: 09/25/2008
Last Update Date: 11/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 ARMORY LANE
VERGENNES VT
05491
US

IV. Provider business mailing address

104 PORTER DRIVE
MIDDLEBURY VT
05753
US

V. Phone/Fax

Practice location:
  • Phone: 802-388-5682
  • Fax: 802-388-5692
Mailing address:
  • Phone: 802-388-5682
  • Fax: 802-388-5692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number101-0041875
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: