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General NPI Number Information
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NPI Number | 1205458056
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Entity Type | Individual
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Provider Name | ELISA VAUTIER RN
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Gender | Female
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Dates
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Enumeration Date | 05/15/2020
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Last Update Date | 02/08/2024
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Provider Practice Location Address
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Address Line | 353 BLAIR PARK RD
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City | WILLISTON
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State | VT
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Zip | 05495-7530
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Country | US
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Telephone | 802-847-1470
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Fax |
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Provider Business Mailing Address
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Address Line | 14 MEADOWVIEW DR
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City | HUNTINGTON
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State | VT
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Zip | 05462-9516
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Country | US
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Telephone | 406-599-8603
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 101.0134562
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 101.0134562
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License Number State | VT
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 026.0132550
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License Number State | VT
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