Provider Demographics
NPI:1962511048
Name:BUSHWELLER, SARAH H (PA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:H
Last Name:BUSHWELLER
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Gender:F
Credentials:PA
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Mailing Address - Street 1:PO BOX 547
Mailing Address - Street 2:CVMC MEDICAL GROUP PRACTICES
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-0547
Mailing Address - Country:US
Mailing Address - Phone:802-371-5326
Mailing Address - Fax:802-371-5339
Practice Address - Street 1:156 MAIN ST
Practice Address - Street 2:MONTPELIER HEALTH CENTER
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-2702
Practice Address - Country:US
Practice Address - Phone:802-223-4738
Practice Address - Fax:802-223-6067
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VT055-0030758363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant