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General NPI Number Information
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NPI Number | 1376274167
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Entity Type | Individual
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Provider Name | BRIGID JOANNA MEEHAN-BRESE
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Gender | Female
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Dates
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Enumeration Date | 06/22/2022
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Last Update Date | 08/12/2022
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Provider Practice Location Address
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Address Line | 44 S MAIN ST
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City | RANDOLPH
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State | VT
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Zip | 05060-1381
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Country | US
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Telephone | 802-728-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 42 CENTER OF TOWN RD
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City | HARTLAND
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State | VT
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Zip | 05048-9595
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Country | US
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Telephone | 802-595-3862
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 101.0135577
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License Number State | VT
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