Provider Demographics
NPI:1851365811
Name:CLEGG, ANNE N (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:N
Last Name:CLEGG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3561 NASHVILLE RD
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:VT
Mailing Address - Zip Code:05465-9503
Mailing Address - Country:US
Mailing Address - Phone:802-656-3340
Mailing Address - Fax:802-656-8022
Practice Address - Street 1:3561 NASHVILLE RD
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:VT
Practice Address - Zip Code:05465-9503
Practice Address - Country:US
Practice Address - Phone:802-656-3340
Practice Address - Fax:802-656-8022
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-00109472084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1011735Medicaid
VT1011735Medicaid
VTI41794Medicare UPIN