# FIDDLEHEAD LEDGE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** NORTHERN GREEN MOUNTAIN FAMILY PRACTICE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669146510
- **Authorized official:** KRISTINA DUPRAT APRN FNP-C (OWNER)
- **Authorized official phone:** (802) 933-5702

## Contact information

- **Practice address:** 12 CHURCH ST, SWANTON, VT 05488-1447
- **Practice address phone:** (802) 868-3175
- **Mailing address:** 67 SHAWVILLE RD, SHELDON, VT 05483-8383
- **Mailing address phone:** (802) 933-5702

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/04/2021
- **Last updated:** 08/04/2021