NPI 1629452156 · live from the CMS NPI Registry
Amie Frederick, PA-C
Physician Assistant in Burlington, VT. National Provider Identifier 1629452156, active.
NPI record
| NPI | 1629452156 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 111 Colchester Ave, Burlington, VT 05401 |
| Practice phone | 802-847-4570 |
| Mailing address | 305 Flanders Rd, East Lyme, CT 06333 |
| Enumerated | July 15, 2015 |
| Last updated | April 5, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | 003828 (CT) |
| Physician Assistant | 363A00000X | 0110-005632 (VA) |
| Physician Assistant | 363A00000X | 0004295 (CO) |
| Physician Assistant primary | 363A00000X | 055-0031625 (VT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.