NPI 1336730498 · live from the CMS NPI Registry
Carissa Ann Brooks
Physician Assistant, Medical in Wilder, VT. National Provider Identifier 1336730498, active.
NPI record
| NPI | 1336730498 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Medical 363AM0700X |
| Practice location | 221 Gillette Street, Wilder, VT 05088 |
| Practice phone | 518-424-7648 |
| Mailing address | Po Box 863, Wilder, VT 05088 |
| Enumerated | February 1, 2021 |
| Last updated | February 1, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Medical primary | 363AM0700X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.