Provider Demographics
NPI:1568676591
Name:DWAN, PAULA GRIFFIN (NP)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:GRIFFIN
Last Name:DWAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 WESTVIEW RD STE 302
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-8025
Mailing Address - Country:US
Mailing Address - Phone:802-655-8888
Mailing Address - Fax:
Practice Address - Street 1:105 WESTVIEW RD STE 302
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-8025
Practice Address - Country:US
Practice Address - Phone:802-655-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0137335363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT101.0137335OtherVERMONT APRN LICENSE