Provider Demographics
NPI:1578599874
Name:CALTRIDER, JARRETT (APRN)
Entity Type:Individual
Prefix:
First Name:JARRETT
Middle Name:
Last Name:CALTRIDER
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-2965
Mailing Address - Country:US
Mailing Address - Phone:802-254-2291
Mailing Address - Fax:
Practice Address - Street 1:80 LINDEN ST
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-2965
Practice Address - Country:US
Practice Address - Phone:802-254-2291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101-0023338163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTNS2036Medicare PIN