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General NPI Number Information
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NPI Number | 1366118937
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Entity Type | Individual
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Provider Name | SARAH STOUT PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/23/2021
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Last Update Date | 07/26/2023
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Provider Practice Location Address
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Address Line | 57 WESTERN AVE
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City | BRATTLEBORO
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State | VT
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Zip | 05301-6093
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Country | US
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Telephone | 802-254-0252
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Fax | 802-254-0253
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Provider Business Mailing Address
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Address Line | 171 RIVER RD
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City | LEYDEN
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State | MA
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Zip | 01337-9740
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Country | US
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Telephone | 413-313-8285
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 101.0134939
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License Number State | VT
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