MEDICARE: GUSSIE LOGAN 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
1	363LF0000X	Family Nurse Practitioner	101.0134357	VT

General Provider Information

NPI Number	:	1881253714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUSSIE LOGAN NP

Provider Business Mailing Address
First Line	:	600 BLAIR PARK RD STE 285
Second Line	:
City	:	WILLISTON
State	:	VT
Zip	:	05495-7586
Country	:	US
Telephone Number	:	802-288-1140
Fax Number	:	802-288-1144

Provider Business Practice Location Address
First Line	:	1127 NORTH AVE STE 1
Second Line	:
City	:	BURLINGTON
State	:	VT
Zip	:	05408-2756
Country	:	US
Telephone Number	:	802-846-8105
Fax Number	:	802-846-8107

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2019
Last Update Date	:	06/30/2023

Similar Medicare Providers

1831207216 — MARTINS FOODS OF SOUTH BURLINGTON LLC
Practice Location Address:

1127 NORTH AVE STE 11
BURLINGTON, VT
05408-2756

Practice Phone: 802-862-7752
Practice Fax: 802-862-7815

1629254990 — ETHAN ALLEN OPTICAL
Practice Location Address:

1127 NORTH AVE STE 34
BURLINGTON, VT
05408-2756

Practice Phone: 802-658-6700
Practice Fax:

1043806789 — ALAN MCCAMPBELL RPH
Practice Location Address:

1127 NORTH AVE STE 11
BURLINGTON, VT
05408-2756

Practice Phone: 802-862-7752
Practice Fax:

1740001262 — VANESSA OROCK
Practice Location Address:

1127 NORTH AVE STE 11
BURLINGTON, VT
05408-2756

Practice Phone: 802-862-8040
Practice Fax:

1225034754 — BACK NORTH CHIROPRACTIC CARE PLC
Practice Location Address:

1127 NORTH AVE , STE 21
BURLINGTON, VT
05401-2756

Practice Phone: 802-652-0015
Practice Fax: 802-652-0016

1669477188 — DR. DANIEL S WEBER D.C.
Practice Location Address:

1127 NORTH AVE , STE 21
BURLINGTON, VT
05401-2756

Practice Phone: 802-652-0015
Practice Fax: 802-652-0016

Directions to “ GUSSIE LOGAN NP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.