Provider Demographics
NPI:1902909922
Name:ALDRICH, CHRISTIE JUDD (FNP)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:JUDD
Last Name:ALDRICH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 ALDRICH LN
Mailing Address - Street 2:
Mailing Address - City:ORLEANS
Mailing Address - State:VT
Mailing Address - Zip Code:05860-9321
Mailing Address - Country:US
Mailing Address - Phone:802-754-2336
Mailing Address - Fax:
Practice Address - Street 1:488 ELM ST
Practice Address - Street 2:
Practice Address - City:BARTON
Practice Address - State:VT
Practice Address - Zip Code:05822-8637
Practice Address - Country:US
Practice Address - Phone:802-525-3539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101-0013882363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTONP2334Medicaid
VTP03469Medicare UPIN
VTALNP2334Medicare ID - Type Unspecified