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General NPI Number Information
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NPI Number | 1174201594
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Entity Type | Individual
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Provider Name | PEYTON WINGFIELD APRN FNP
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Gender | Female
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Dates
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Enumeration Date | 07/06/2023
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | 53 TIMBER LN
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City | SOUTH BURLINGTON
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State | VT
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Zip | 05403-5201
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Country | US
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Telephone | 802-864-0294
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Fax |
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Provider Business Mailing Address
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Address Line | 60 WINOOSKI FALLS WAY UNIT 1411
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City | WINOOSKI
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State | VT
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Zip | 05404-2271
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Country | US
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Telephone | 434-660-9175
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 101.0136395
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License Number State | VT
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