Provider Demographics
NPI:1871665422
Name:MIDDLETON, NANCY LAURA (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:LAURA
Last Name:MIDDLETON
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 1:8 WINDRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ESSEX JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05452-3830
Mailing Address - Country:US
Mailing Address - Phone:802-879-3515
Mailing Address - Fax:802-872-5809
Practice Address - Street 1:8 WINDRIDGE RD
Practice Address - Street 2:
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452-3830
Practice Address - Country:US
Practice Address - Phone:802-879-3515
Practice Address - Fax:802-872-5809
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT66212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0006004Medicaid
VT6004OtherBLUE CROSS-CLUE SHIELD
VT0006004Medicaid