Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 101.0125739 | VT |
NPI | 1902358476 |
---|---|
Provider Name | Elise Rozendaal |
First Address | Morrisville, VT 05661-0749 |
Second Address | Morrisville, VT 05661-8652 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2016 |
Last Update Date | 04/06/2021 |