Provider Demographics
NPI:1215264254
Name:PRINGLE, BROOKE E (PAC)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:E
Last Name:PRINGLE
Suffix:
Gender:F
Credentials:PAC
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 710
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05156-0710
Mailing Address - Country:US
Mailing Address - Phone:802-463-9000
Mailing Address - Fax:802-463-1290
Practice Address - Street 1:1 HOSPITAL CT
Practice Address - Street 2:
Practice Address - City:BELLOWS FALLS
Practice Address - State:VT
Practice Address - Zip Code:05101-1489
Practice Address - Country:US
Practice Address - Phone:802-463-9000
Practice Address - Fax:802-463-1290
Is Sole Proprietor?:No
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant