Basic Information
| Provider Information | |||||||||
| NPI: | 1497711220 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CALDERWOOD | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 165 SHERMAN DR | ||||||||
| Address2: | |||||||||
| City: | ST JOHNSBURY | ||||||||
| State: | VT | ||||||||
| PostalCode: | 058199811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8027489405 | ||||||||
| FaxNumber: | 8027484540 | ||||||||
| Practice Location | |||||||||
| Address1: | 4 SLAPP HILL ROAD | ||||||||
| Address2: | |||||||||
| City: | HARDWICK | ||||||||
| State: | VT | ||||||||
| PostalCode: | 05843 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8024723300 | ||||||||
| FaxNumber: | 8024728277 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2006 | ||||||||
| LastUpdateDate: | 07/26/2010 | ||||||||
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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 | 363LF0000X | 101-0011178 | VT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 0008916 | 05 | VT | MEDICAID |