Provider Demographics
NPI:1801061973
Name:STANDISH, ANNE T (NPP)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:T
Last Name:STANDISH
Suffix:
Gender:F
Credentials:NPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4178 HIGHBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VT
Mailing Address - Zip Code:05454-5446
Mailing Address - Country:US
Mailing Address - Phone:802-524-9595
Mailing Address - Fax:802-524-2867
Practice Address - Street 1:4178 HIGHBRIDGE RD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VT
Practice Address - Zip Code:05454-5446
Practice Address - Country:US
Practice Address - Phone:802-524-9595
Practice Address - Fax:802-524-2867
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101-0017609363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1014907Medicaid
VT000813301Medicare PIN