Individual
CAREY J BRODZINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
185 SHERMAN DRIVE, SUITE 1, ST JOHNSBURY, VT 05819
(802) 748-5041
(802) 748-5094
Mailing address
165 SHERMAN DR, ST JOHNSBURY, VT 05819-9811
(802) 748-9405
(802) 748-4540
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1010020383
VT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
101-0020383
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0NP2800
—
VT
01
—
P21615
MEDICARE PROVIDER NUMBER
VT
Enumeration date
04/19/2006
Last updated
09/20/2010
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