Provider Demographics
NPI:1063828036
Name:FOX, AMY M (APRN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:M
Last Name:FOX
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:792 COLLEGE PKWY
Mailing Address - Street 2:SUITE 207
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-3052
Mailing Address - Country:US
Mailing Address - Phone:802-655-3400
Mailing Address - Fax:802-655-9170
Practice Address - Street 1:792 COLLEGE PKWY
Practice Address - Street 2:SUITE 207
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-3052
Practice Address - Country:US
Practice Address - Phone:802-655-3400
Practice Address - Fax:802-655-9170
Is Sole Proprietor?:No
Enumeration Date:2014-07-10
Last Update Date:2014-07-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VT1010105460363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1010105460OtherSTATE OF VERMONT BOARD OF NURSING