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General NPI Number Information
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NPI Number | 1619214574
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Entity Type | Organization
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Legal Business Name | CAROLINE TASSEY PLC
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Dates
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Enumeration Date | 01/12/2013
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Last Update Date | 06/28/2015
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Provider Practice Location Address
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Address Line | 1205 NORTH AVE
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City | BURLINGTON
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State | VT
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Zip | 05408-2804
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Country | US
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Telephone | 802-489-5665
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Fax | 802-419-5300
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Provider Business Mailing Address
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Address Line | 33 HOLLY LN
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City | BURLINGTON
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State | VT
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Zip | 05408-2621
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Country | US
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Telephone | 802-598-4006
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Fax | 802-316-4208
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Authorized Official
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Title or Position | PMHNP
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Name | MS. CAROLINE TASSEY
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Credential | NP
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Telephone | 802-318-1907
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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 | 101-0016244
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License Number State | VT
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