MEDICARE: REBECCA A LEVASSEUR-OETTINGER 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	363LW0102X	Women's Health Nurse Practitioner	1010012034	VT

General Provider Information

NPI Number	:	1912954629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA A LEVASSEUR-OETTINGER NP

Provider Business Mailing Address
First Line	:	784 HERCULES DR STE 110
Second Line	:
City	:	COLCHESTER
State	:	VT
Zip	:	05446-8049
Country	:	US
Telephone Number	:	802-448-9719
Fax Number	:

Provider Business Practice Location Address
First Line	:	183 SAINT PAUL ST
Second Line	:
City	:	BURLINGTON
State	:	VT
Zip	:	05401-4636
Country	:	US
Telephone Number	:	802-863-6326
Fax Number	:

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

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	07/12/2016

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