Provider Demographics
NPI:1982984316
Name:COREY, JORDICE B (APRN)
Entity Type:Individual
Prefix:
First Name:JORDICE
Middle Name:B
Last Name:COREY
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:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05661-0749
Mailing Address - Country:US
Mailing Address - Phone:802-851-8619
Mailing Address - Fax:802-851-8716
Practice Address - Street 1:609 WASHINGTON HWY
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:VT
Practice Address - Zip Code:05661-8652
Practice Address - Country:US
Practice Address - Phone:802-888-5639
Practice Address - Fax:802-888-6040
Is Sole Proprietor?:No
Enumeration Date:2011-08-17
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101-0082960363LF0000X
VT0260043274363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1019989Medicaid
VTY400159163Medicare PIN
VT1019989Medicaid