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General NPI Number Information
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NPI Number | 1790956738
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Entity Type | Individual
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Provider Name | CHRISTINE M MALCOLM CNM, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 04/05/2021
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Provider Practice Location Address
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Address Line | 1878 MOUNTAIN RD
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City | STOWE
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State | VT
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Zip | 05672-4776
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Country | US
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Telephone | 802-253-4853
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Fax | 802-496-5586
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Provider Business Mailing Address
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Address Line | PO BOX 749
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City | MORRISVILLE
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State | VT
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Zip | 05661-0749
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Country | US
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Telephone | 802-851-8704
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Fax | 802-496-5586
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 039145-23
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 039145-23
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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 | 1010021863
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License Number State | VT
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