Organization
NORTHEAST KINGDOM HEALTHCARE COLLABORATIVE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH L BROWN (ENROLLMENT SPECIALIST)
(802) 487-2589
Entity
Organization
Contact information
Practice address
468 HOSPITAL DRIVE, ST JOHNSBURY, VT 05819
(802) 748-7901
(802) 427-3047
Mailing address
186 MEDICAL VILLAGE DR, SUITE 1, NEWPORT, VT 05855
(802) 487-2589
(802) 334-3281
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1019637
—
VT
Enumeration date
08/17/2011
Last updated
09/24/2025
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