Provider Demographics
NPI:1679769798
Name:LURIA, JANE A (APRN)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:A
Last Name:LURIA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:SAINT MICHAEL'S COLLEGE, BERGERON WELLNESS CENTER
Mailing Address - Street 2:1 WINOOSKI PARK, BOX 259
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05439-6491
Mailing Address - Country:US
Mailing Address - Phone:802-654-2234
Mailing Address - Fax:802-654-2699
Practice Address - Street 1:1 WINOOSKI PARK
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05439-6491
Practice Address - Country:US
Practice Address - Phone:802-654-2234
Practice Address - Fax:802-654-2699
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101-0017629363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner