NPI 1457750234 · live from the CMS NPI Registry
Samantha Burnham Ingerick, NP
Nurse Practitioner, Pediatrics in Manchester, VT. National Provider Identifier 1457750234, active.
NPI record
| NPI | 1457750234 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 4384 Main Street, Manchester, VT 05254 |
| Practice phone | 802-768-9136 |
| Mailing address | Po Box 255, Manchester, VT 05254 |
| Enumerated | August 18, 2014 |
| Last updated | October 23, 2023 |
| Sole proprietor | Yes |
| Other names | Smantha Burnham |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics | 363LP0200X | F382385-1 (NY) |
| Nurse Practitioner, Pediatrics | 363LP0200X | 088196-23 (NH) |
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 101.0134299 (VT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.