Provider Demographics
NPI:1942370218
Name:SCHACHT, IRENE MARIA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:IRENE
Middle Name:MARIA
Last Name:SCHACHT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 GALVIN RD
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:VT
Mailing Address - Zip Code:05778-4400
Mailing Address - Country:US
Mailing Address - Phone:802-458-2122
Mailing Address - Fax:
Practice Address - Street 1:84 GALVIN RD
Practice Address - Street 2:
Practice Address - City:WHITING
Practice Address - State:VT
Practice Address - Zip Code:05778-4400
Practice Address - Country:US
Practice Address - Phone:802-458-2122
Practice Address - Fax:802-623-6732
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0134276363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTPENDINGMedicaid
CTR43203OtherRN LICENSE #
CTPENDING - C00814Medicare PIN
CTPENDINGMedicaid