| NPI | 1609966944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE ESTES Credentialing Rep 802-748-9405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VT 1010016293) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2020-08-22 |