Waters, Brenda Lorraine
Waters, Brenda Lorraine is an individual health care provider with primary practice located at 111 Colchester Ave , Burlington VT 05401-1473. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anatomic Pathology, Allopathic & Osteopathic Physicians / Pediatric Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology is her primary health care specialty. Waters, Brenda Lorraine can be contacted via phone (802) 847-2797.Contact Information
Primary practice address
111 Colchester Ave
Burlington VT 05401-1473
Phone: (802) 847-2797
Fax: (802) 847-9644
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology | 207ZP0101X | 042-0006733 | Vermont |
| Allopathic & Osteopathic Physicians / Pediatric Pathology | 207ZP0213X | 042-0006733 | Vermont |
Profile Details
| NPI number | 1366477960 |
|---|---|
| LBN Legal business name | Waters, Brenda Lorraine |
| Credentials | M.D., B.S. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 11th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1366477960 | NPPES |
| New York | MEDICAID | 01166976 | |
| New York | MEDICAID | 0009551 |
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