# NORTHWESTERN MEDICAL CENTER, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487476867
- **Authorized official:** THERESE M TUCKER (ENROLLMENT SPECIALIST)
- **Authorized official phone:** (802) 524-8954

## Contact information

- **Practice address:** 260 CREST RD STE 204, SAINT ALBANS, VT 05478-9502
- **Practice address phone:** (802) 752-1992
- **Practice address fax:** (802) 752-1993
- **Mailing address:** 133 FAIRFIELD ST, SAINT ALBANS, VT 05478-1726
- **Mailing address phone:** (802) 524-5911

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/28/2024
- **Last updated:** 10/28/2024