Durrelle T Whitmore, APNP
Individual provider Active NPI Nurse Practitioner · East Corinth, VT
NPI 1609888684 · NPPES record last updated Oct 2, 2014
Key facts
- NPI
- 1609888684
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 1010101436 (VT)
- Practice address
- 720 Village Road
East Corinth, VT 05040 - Phone
- (802) 439-5321
- NPI assigned
- Aug 11, 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)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1010101436 | VT | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP60303523 | WA | |
| Nurse Practitioner | 363L00000X | 1010101436 | VT | Yes |
| Nurse Practitioner | 363L00000X | 1813 | WI |
Addresses
Primary practice location
720 Village Road
East Corinth, VT 05040
Mailing address
4 Skunk Hollow Rd
East Hardwick, VT 05836-9739
Phone (802) 533-7084
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609888684 | Medicaid | WA | |
| 43943700 | Medicaid | WV | |
| 1023061 | Medicaid | VT |
Other providers in East Corinth, VT
All providers in East Corinth, VT · Nurse Practitioner in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.