Jennifer April Civiello, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1010031684 Issued in VT

Practice address

331 Upper Plain
Bradford, VT 05033

Phone

(802) 222-4722

Fax

(802) 222-4709

NPI assigned

Nov 7, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Jennifer April Glidden Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912076803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 PARKHURST ST",
            "address_2": "APT 1",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "03766",
            "telephone_number": "603-448-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 UPPER PLAIN",
            "city": "BRADFORD",
            "state": "VT",
            "postal_code": "05033",
            "telephone_number": "802-222-4722",
            "fax_number": "802-222-4709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIVIELLO",
        "first_name": "JENNIFER",
        "middle_name": "APRIL",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VT",
            "license": "1010031684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30344253",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012431",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "GLIDDEN",
            "middle_name": "APRIL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa Cadow, MA
• Renee Boudreau Cather
• Danielle Cayton, MA, LADC
• Lora Oakes Chatfield, CNM
• Margarethe M Chobanian, M.D.
• Robert William Claflin, LCMHC
• Thomas Clark, MD
• Kevin J. Connolly, M.D.
• Hilary Watts Coons, PHD
• Tanya Rebekah Croke, LISCW

• Pediatric Nurse Practitioner in Bradford, VT
• Providers in Bradford, VT by specialty
• Pediatric Nurse Practitioner in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.