Provider Demographics
NPI:1831872993
Name:FREDETTE, CRISTINA (APRN)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:FREDETTE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CRISTINA
Other - Middle Name:
Other - Last Name:FREDETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 COMMONS ST
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-4651
Mailing Address - Country:US
Mailing Address - Phone:802-775-1905
Mailing Address - Fax:802-775-5503
Practice Address - Street 1:6 COMMONS ST
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4651
Practice Address - Country:US
Practice Address - Phone:802-775-1905
Practice Address - Fax:802-775-5503
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT026.0038522163W00000X
VT101.0136485363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse