Elizabeth A Derry, RD, CD, CDE

Individual provider Active NPI Registered Dietitian · Windsor, VT

NPI 1821084302 · NPPES record last updated Dec 19, 2008

Key facts

NPI
1821084302
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
074-0000187 (VT)
Practice address
289 County Rd
Windsor, VT 05089-9000
Phone
(802) 674-7300
Fax
(802) 674-7314
NPI assigned
Sep 21, 2005
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

State licenses

LicenseStateTypeSpecialty
074-0000187VTMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 074-0000187 VT Yes

Addresses

Primary practice location

289 County Rd
Windsor, VT 05089-9000

Mailing address

289 County Rd
Windsor, VT 05089-9000
Phone (802) 674-7300

Other providers in Windsor, VT

All providers in Windsor, VT · Registered Dietitian in Vermont

Sources for this page

Verify at the official NPI Registry.