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Organization
NORTHWESTERN MEDICAL CENTER, INC.
Active
Organization
NORTHWESTERN MEDICAL CENTER, INC.
Active
Other names
Northwestern Lifestyle Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MARY E PIGEON (CREDENTIALING SPECIALIST)
(802) 524-8954
Entity
Organization
Contact information
Practice address
133 FAIRFIELD ST, SAINT ALBANS, VT 05478-1726
(802) 524-1227
(802) 524-8498
Mailing address
133 FAIRFIELD ST, SAINT ALBANS, VT 05478-1726
(802) 524-5911
(802) 527-1057
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
NULL
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
133V00000X
Registered Dietitian
—
NULL
133V00000X
Registered Dietitian
—
—
136A00000X
Registered Dietetic Technician
—
NULL
136A00000X
Registered Dietetic Technician
—
—
Other
Enumeration date
11/13/2018
Last updated
11/13/2018
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