Provider Demographics
NPI:1043712342
Name:FASCI, LINDA ANN (APRN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ANN
Last Name:FASCI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 PIERCE RD UNIT 2
Mailing Address - Street 2:
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-9741
Mailing Address - Country:US
Mailing Address - Phone:508-989-8259
Mailing Address - Fax:
Practice Address - Street 1:118 CLARK RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:VT
Practice Address - Zip Code:05679-9449
Practice Address - Country:US
Practice Address - Phone:508-989-8259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0132412363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care