Provider Demographics
NPI:1669452835
Name:TOWLE, PATRICIA
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:TOWLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:TOWLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:VT
Mailing Address - Zip Code:05444-0102
Mailing Address - Country:US
Mailing Address - Phone:802-899-1862
Mailing Address - Fax:
Practice Address - Street 1:272 N MAIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CAMBRIDGE
Practice Address - State:VT
Practice Address - Zip Code:05444-9810
Practice Address - Country:US
Practice Address - Phone:802-644-5114
Practice Address - Fax:802-644-5573
Is Sole Proprietor?:No
Enumeration Date:2006-01-22
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101-0023655363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTONP1765Medicaid
VTNP176501Medicare PIN
VTONP1765Medicaid