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General NPI Number Information
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NPI Number | 1801746912
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Entity Type | Individual
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Provider Name | BRENNA GRISWOLD
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Gender | Female
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Dates
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Enumeration Date | 01/29/2026
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 133 FAIRFIELD ST
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City | SAINT ALBANS
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State | VT
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Zip | 05478-1726
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Country | US
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Telephone | 802-524-5911
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Fax |
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Provider Business Mailing Address
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Address Line | 1528 LAKE RD
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City | MILTON
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State | VT
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Zip | 05468-4130
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Country | US
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Telephone | 802-233-4760
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 101.0138781
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License Number State | VT
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