Individual
BRIDGET M. THABAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-8200
(802) 847-8742
Mailing address
122 CHERRY LN, BURLINGTON, VT 05401-4909
(802) 862-9026
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1010019110
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010708
—
VT
Enumeration date
07/18/2006
Last updated
07/08/2007
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