P Spencer Burdge, APRN

Individual provider Active NPI Gerontology Nurse Practitioner · White River Junction, VT

NPI 1043328693 · NPPES record last updated Jul 13, 2007

Key facts

NPI
1043328693
Entity type
Individual (NPI type 1)
Primary specialty
Gerontology Nurse Practitioner 363LG0600X
License
135263 (MA)
Practice address
Vamc 116a
215 N. Main St
White River Junction, VT 05009-0001
Phone
(802) 295-8363
NPI assigned
Aug 25, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
135263MAMDGerontology Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 135263 MA Yes

Addresses

Primary practice location

Vamc 116a
215 N. Main St
White River Junction, VT 05009-0001

Mailing address

Vamc 116a
215 N. Main St
White River Junction, VT 05009-0001
Phone (802) 295-8363

Other providers in White River Junction, VT

All providers in White River Junction, VT · Gerontology Nurse Practitioner in Vermont

Sources for this page

Verify at the official NPI Registry.