Individual
DR. BRENDA LORRAINE WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., B.S.
Contact information
Practice address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-2797
(802) 847-9644
Mailing address
300 BLACKBERRY DR, HUNTINGTON, VT 05462-9640
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
042-0006733
VT
207ZP0213X
Pediatric Pathology Physician
Primary
042-0006733
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009551
—
VT
05
—
01166976
—
NY
Enumeration date
07/11/2006
Last updated
09/11/2025
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