Basic Information
| Provider Information | |||||||||
| NPI: | 1902909922 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALDRICH | ||||||||
| FirstName: | CHRISTIE | ||||||||
| MiddleName: | JUDD | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 193 ALDRICH LN | ||||||||
| Address2: | |||||||||
| City: | ORLEANS | ||||||||
| State: | VT | ||||||||
| PostalCode: | 058609321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8027542336 | ||||||||
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| Practice Location | |||||||||
| Address1: | 488 ELM ST | ||||||||
| Address2: | |||||||||
| City: | BARTON | ||||||||
| State: | VT | ||||||||
| PostalCode: | 058228637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8025253539 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2006 | ||||||||
| LastUpdateDate: | 04/30/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 101-0013882 | VT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | ONP2334 | 05 | VT | MEDICAID |