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General NPI Number Information
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NPI Number | 1124357215
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Entity Type | Individual
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Provider Name | LEAH MARIETTE MACAULAY P.N.P
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Gender | Female
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Dates
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Enumeration Date | 12/18/2009
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 595 DORSET ST STE 4
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City | SOUTH BURLINGTON
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State | VT
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Zip | 05403-6240
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Country | US
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Telephone | 802-489-5552
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Fax |
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Provider Business Mailing Address
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Address Line | 600 BLAIR PARK RD STE 285
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City | WILLISTON
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State | VT
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Zip | 05495-7586
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Country | US
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Telephone | 802-288-1140
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Fax | 802-288-1144
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 101.0060740
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 101.0060740
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License Number State | VT
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