Vandervort, Elisa Brettler

Vandervort, Elisa Brettler is an individual health care provider with primary practice located at 246 Granger Rd Ste 2 , Berlin VT 05602. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Vandervort, Elisa Brettler can be contacted via phone (802) 225-5810.

Contact Information

Primary practice address
246 Granger Rd Ste 2 Berlin VT 05602
Phone: (802) 225-5810
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 101-0026277 Vermont
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 101-0026277 Vermont

Profile Details

NPI number 1598741019
LBN Legal business name Vandervort, Elisa Brettler
Credentials FNP, CNM
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 16th, 2005
Last updated Nov 8th, 2018 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598741019 NPPES
Vermont MEDICAID 0NP4077

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