Basic Information
| Provider Information | |||||||||
| NPI: | 1255384889 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CABRI | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | JEWEL | ||||||||
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| Credential: | APRN, CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX G | ||||||||
| Address2: | |||||||||
| City: | RANDOLPH | ||||||||
| State: | VT | ||||||||
| PostalCode: | 050600167 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8027284466 | ||||||||
| FaxNumber: | 8027284197 | ||||||||
| Practice Location | |||||||||
| Address1: | 1740 LOWER PLN | ||||||||
| Address2: | |||||||||
| City: | BRADFORD | ||||||||
| State: | VT | ||||||||
| PostalCode: | 050338934 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8027284466 | ||||||||
| FaxNumber: | 8027284197 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2006 | ||||||||
| LastUpdateDate: | 07/27/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | 1010013550 | VT | N | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | 363LF0000X | 101-0013550 | VT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | MC1926217 | 01 | DEA | OTHER | 0001807 | 05 | VT | MEDICAID |