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Individual
MRS. ALICE CECILE PEZZULICH
Active
Individual
MRS. ALICE CECILE PEZZULICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0027640
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00059357
VERMONT BLUE CROSS
VT
05
—
0473830
—
VT
01
—
414900
CIGNA
—
01
—
696890
MVP HEALTHPLAN
—
01
—
GONP4075
CHAMPUS/TRICARE
—
05
—
ONP4075
—
VT
Enumeration date
09/26/2005
Last updated
06/23/2015
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