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NPI Code Detail

MEDICARE: AYLA R PRIESTLEY NP

MEDICARE: AYLA R PRIESTLEY NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner101.0134265VT

General Provider Information

NPI Number : 1679038806
Entity Type Code : Individual
Provider Name (Legal Business Name) : AYLA R PRIESTLEY NP
Provider Business Mailing Address
First Line : 538 UPPER PLN
Second Line :
City : BRADFORD
State : VT
Zip : 05033-9006
Country : US
Telephone Number : 603-359-2287
Fax Number :
Provider Business Practice Location Address
First Line : 437 S MAIN ST
Second Line :
City : BRADFORD
State : VT
Zip : 05033-9196
Country : US
Telephone Number : 802-222-9317
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2019
Last Update Date : 02/01/2019

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