Individual
MS. CHRISTINE M MALCOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, FNP-BC
Contact information
Practice address
1878 MOUNTAIN RD, STOWE, VT 05672-4776
(802) 253-4853
(802) 496-5586
Mailing address
PO BOX 749, MORRISVILLE, VT 05661-0749
(802) 851-8704
(802) 496-5586
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
039145-23
NH
363LF0000X
Family Nurse Practitioner
Primary
1010021863
VT
367A00000X
Advanced Practice Midwife
039145-23
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0NP0315
—
VT
01
—
VN200903
MEDICARE PTAN LINKED TO CVMC MGP
VT
Enumeration date
03/18/2008
Last updated
04/05/2021
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