Provider Demographics
NPI:1093598351
Name:NIMTZ, ISOBEL GABEL (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ISOBEL
Middle Name:GABEL
Last Name:NIMTZ
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 LEONARD ST
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-3339
Mailing Address - Country:US
Mailing Address - Phone:828-707-1683
Mailing Address - Fax:
Practice Address - Street 1:231 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-2412
Practice Address - Country:US
Practice Address - Phone:802-772-7992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-18
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0136446363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health