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General NPI Number Information
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NPI Number | 1427283282
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Entity Type | Organization
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Legal Business Name | MID VERMONT HEALTHCARE
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Dates
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Enumeration Date | 05/22/2009
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Last Update Date | 05/22/2009
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Provider Practice Location Address
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Address Line | 69 ALLEN ST SUITE 10
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City | RUTLAND
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State | VT
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Zip | 05701-4564
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Country | US
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Telephone | 802-786-9063
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Fax | 802-747-4532
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Provider Business Mailing Address
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Address Line | 69 ALLEN ST SUITE 10
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City | RUTLAND
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State | VT
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Zip | 05701-4564
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Country | US
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Telephone | 802-786-9063
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Fax | 802-747-4532
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KIMBERLY A EUGAIR
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Credential | F,NP
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Telephone | 802-786-9063
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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 | 1010021584
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License Number State | VT
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