SUZANNE CARLISLE STEBENNE NPI 1083135461

NPI Information

NPI: 1083135461
Provider Name: SUZANNE CARLISLE STEBENNE

Doing Business As: IDEAL PRIMARY CARE

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
212 HOLIDAY DR STE 4
WHITE RIVER JUNCTION, VT
ZIP 05001
Phone: (202) 394-9166
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SUZANNE CARLISLE STEBENNE is a family nurse practitioner in White River Junction, VT. SUZANNE CARLISLE STEBENNE NPI is 1083135461. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Ideal Primary Care.

The provider's business location address is:

212 HOLIDAY DR STE 4
WHITE RIVER JUNCTION, VT
ZIP 05001-044
Phone: (202) 394-9166

The provider's authorized official is Suzanne Carlisle Stebenne .
The authorized official title is Family Nurse Practitioner and has the following contact phone number (202) 394-9166.

The CLIA number assigned to this NPI record is 47D2133967 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/6/2017 and was last updated on 7/6/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	101.0110101	VERMONT	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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