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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
MRS. MARY PIGEON (CREDENTIALING SPECIALIST)
(802) 524-8954
Entity
Organization
Contact information
Practice address
260 CREST RD, SUITE 202, SAINT ALBANS, VT 05478-9503
(802) 524-1227
(802) 524-8498
Mailing address
133 FAIRFIELD ST, SAINT ALBANS, VT 05478-1726
(802) 524-1227
(802) 524-8498
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
03/15/2007
Last updated
10/23/2018
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