Basic Information
Provider Information
NPI: 1205298015
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TERRIEN
FirstName: MARGARET
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 208 FLYNN AVE
Address2: STE 3J
City: BURLINGTON
State: VT
PostalCode: 054010000
CountryCode: US
TelephoneNumber: 8024886934
FaxNumber:  
Practice Location
Address1: 855 PINE ST
Address2:  
City: BURLINGTON
State: VT
PostalCode: 054014924
CountryCode: US
TelephoneNumber: 8024886300
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/22/2016
LastUpdateDate: 03/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200X101.0012228VTY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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