Provider Demographics
NPI:1083397806
Name:DUMAS, MARIE P (ACNP-AG)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:P
Last Name:DUMAS
Suffix:
Gender:F
Credentials:ACNP-AG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 HOSPITAL DRIVE
Mailing Address - Street 2:ICU
Mailing Address - City:ST-JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819
Mailing Address - Country:US
Mailing Address - Phone:802-673-8378
Mailing Address - Fax:
Practice Address - Street 1:1315 HOSPITAL DR.
Practice Address - Street 2:ICU- NORTH EASTERN VERMONT REGIONAL HOSPITAL
Practice Address - City:ST. JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819
Practice Address - Country:US
Practice Address - Phone:802-673-8378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-09
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0136442363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care