Provider Demographics
NPI:1528169984
Name:ONOFRIO, ANITA MARIE (CNM)
Entity type:Individual
Prefix:MS
First Name:ANITA
Middle Name:MARIE
Last Name:ONOFRIO
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 VAN DYKE RD
Mailing Address - Street 2:
Mailing Address - City:STRAFFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05072-9785
Mailing Address - Country:US
Mailing Address - Phone:802-765-4507
Mailing Address - Fax:802-763-2190
Practice Address - Street 1:31 HANOVER ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1357
Practice Address - Country:US
Practice Address - Phone:603-413-0394
Practice Address - Fax:603-413-0394
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH025013-23363LP0808X, 367A00000X
VT1010014619367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3098195Medicaid
VT22390YMedicare UPIN