Provider Demographics
NPI:1134573900
Name:TOLSTOI, JORDAN F (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JORDAN
Middle Name:F
Last Name:TOLSTOI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:JORDAN
Other - Middle Name:W
Other - Last Name:FERRIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:111 COLCHESTER AVE
Mailing Address - Street 2:UVM MEDICAL CENTER-WOMEN'S HEALTH
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-1473
Mailing Address - Country:US
Mailing Address - Phone:802-847-5800
Mailing Address - Fax:
Practice Address - Street 1:111 COLCHESTER AVE
Practice Address - Street 2:UVM MEDICAL CENTER-WOMEN'S HEALTH
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1473
Practice Address - Country:US
Practice Address - Phone:802-847-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT9000853Medicaid
VT9000853Medicaid