Provider Demographics
NPI:1447544127
Name:WESTERVELT, ANNA M (APRN)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:M
Last Name:WESTERVELT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-0001
Mailing Address - Country:US
Mailing Address - Phone:603-650-5402
Mailing Address - Fax:802-847-7433
Practice Address - Street 1:ONE MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-0001
Practice Address - Country:US
Practice Address - Phone:603-650-5402
Practice Address - Fax:802-847-7433
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP37602363L00000X
VT101.0094734363LF0000X
NH082902-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI002176201OtherRI MEDICARE
RI08112011OtherNHPRI
MA110088970AMedicaid
VT002176202OtherMEDICARE PTAN LINKED TO CVMC
RI07232011OtherBCBSRI
VT1021788Medicaid
RI939025129OtherRI MEDICARE GROUP
RIAW84976Medicaid