NPI 1063749414 · live from the CMS NPI Registry
Autumn M Bondesen, PA
Physician Assistant, Medical in Richford, VT. National Provider Identifier 1063749414, active.
NPI record
| NPI | 1063749414 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Medical 363AM0700X |
| Practice location | 44 Main St, Suite 200, Richford, VT 05476 |
| Practice phone | 802-255-5500 |
| Mailing address | 6 Ouellet Drive, St Albans, VT 05478 |
| Enumerated | November 5, 2009 |
| Last updated | September 25, 2012 |
| Sole proprietor | No |
| Other names | Autumn Piche |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Medical primary | 363AM0700X | 055-0031000 (VT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.