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General NPI Number Information
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NPI Number | 1558171694
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Entity Type | Individual
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Provider Name | BRIEANNA MCKEAGE BA
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Gender | Female
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Dates
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Enumeration Date | 01/10/2025
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 49 SCHOOL STREET
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City | HARTFORD
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State | VT
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Zip | 05047
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Country | US
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Telephone | 802-295-3031
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Fax | 802-886-4520
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Provider Business Mailing Address
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Address Line | 390 RIVER STREET
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City | SPRINGFIELD
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State | VT
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Zip | 05156
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Country | US
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Telephone | 802-886-4500
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Fax | 802-886-4520
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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