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General NPI Number Information
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NPI Number | 1417795873
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Entity Type | Individual
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Provider Name | REBECCA PROUTY FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/18/2024
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 17 BELMONT AVE
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City | BRATTLEBORO
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State | VT
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Zip | 05301-7601
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Country | US
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Telephone | 802-257-0341
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Fax |
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Provider Business Mailing Address
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Address Line | 37 ERNEST AVE APT 1
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City | EXETER
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State | NH
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Zip | 03833-4346
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Country | US
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Telephone |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 084579-21
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License Number State | NH
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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 | 084579-23
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 101.0137296
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License Number State | VT
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