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General NPI Number Information
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NPI Number | 1982659132
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Entity Type | Individual
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Provider Name | MARLENE M. BRISTOL ARNP
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Gender | Female
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 65 MAIN ST N
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City | WELLS RIVER
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State | VT
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Zip | 05081-9692
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Country | US
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Telephone | 802-757-2325
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Fax | 855-868-7197
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Provider Business Mailing Address
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Address Line | PO BOX 8
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City | NEWBURY
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State | VT
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Zip | 05051-0008
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Country | US
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Telephone | 802-222-3026
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Fax | 855-868-7197
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0370502303
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1010020753
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License Number State | VT
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