Provider Demographics
NPI:1679986327
Name:UNIVERSITY OF VERMONT NURSING AND HEALTH SCIENCES PRACTICE GROUP
Entity Type:Organization
Organization Name:UNIVERSITY OF VERMONT NURSING AND HEALTH SCIENCES PRACTICE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PROFESSOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:DALE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:802-656-3830
Mailing Address - Street 1:PO BOX 506
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05402-0506
Mailing Address - Country:US
Mailing Address - Phone:802-847-0212
Mailing Address - Fax:802-847-1791
Practice Address - Street 1:1205 NORTH AVE
Practice Address - Street 2:APPLETREE BAY PRIMARY CARE
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05408-2804
Practice Address - Country:US
Practice Address - Phone:802-863-1313
Practice Address - Fax:802-863-2396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-10
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty