Provider Demographics
NPI:1235163718
Name:TODD, JOHN WILLIAM (ARNP)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:WILLIAM
Last Name:TODD
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 247, 79 MAIN ST.
Mailing Address - Street 2:PUTNEY FAMILY HEALTHCARE
Mailing Address - City:PUTNEY
Mailing Address - State:VT
Mailing Address - Zip Code:05346-8943
Mailing Address - Country:US
Mailing Address - Phone:802-387-5581
Mailing Address - Fax:
Practice Address - Street 1:79 MAIN ST.,
Practice Address - Street 2:
Practice Address - City:PUTNEY
Practice Address - State:VT
Practice Address - Zip Code:05346
Practice Address - Country:US
Practice Address - Phone:802-387-5581
Practice Address - Fax:802-387-6694
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101-0023475363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30343945Medicaid
NHP99725Medicare UPIN
NHNP5235Medicare ID - Type Unspecified