NPI 1912076803 · live from the CMS NPI Registry
Jennifer April Civiello, CPNP
Nurse Practitioner, Pediatrics in Bradford, VT. National Provider Identifier 1912076803, active.
NPI record
| NPI | 1912076803 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 331 Upper Plain, Bradford, VT 05033 |
| Practice phone | 802-222-4722 |
| Mailing address | 37 Parkhurst St, Apt 1, Lebanon, NH 03766 |
| Enumerated | November 7, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
| Other names | Jennifer Glidden |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 1010031684 (VT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.