Bondesen, Autumn M
Bondesen, Autumn M is an individual health care provider with primary practice located at 44 Main St Suite 200, Richford VT 05476-1153. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Bondesen, Autumn M can be contacted via phone (802) 255-5500.Contact Information
Primary practice address
44 Main St Suite 200
Richford VT 05476-1153
Phone: (802) 255-5500
Fax: (802) 255-5589
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 055-0031000 | Vermont |
Profile Details
| NPI number | 1063749414 |
|---|---|
| LBN Legal business name | Bondesen, Autumn M |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 5th, 2009 |
| Last updated | Sep 25th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063749414 | NPPES |
| Vermont | MEDICAID | 9000445 |
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