Provider Demographics
NPI:1194770263
Name:O'CONNOR, ALISON JAMIE (ARNP)
Entity type:Individual
Prefix:MS
First Name:ALISON
Middle Name:JAMIE
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 755
Mailing Address - Street 2:
Mailing Address - City:WELLS RIVER
Mailing Address - State:VT
Mailing Address - Zip Code:05081-0755
Mailing Address - Country:US
Mailing Address - Phone:802-757-2325
Mailing Address - Fax:
Practice Address - Street 1:65 MAIN ST N
Practice Address - Street 2:
Practice Address - City:WELLS RIVER
Practice Address - State:VT
Practice Address - Zip Code:05081-9692
Practice Address - Country:US
Practice Address - Phone:802-757-2325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1010021916363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30008764Medicaid
VT1009439Medicaid
VTS18961OtherUPIN
VTVX1772Medicare PIN
NH30008764Medicaid