Waters, Brenda Lorraine

Waters, Brenda Lorraine is an individual health care provider with primary practice located at 111 Colchester Ave , Burlington VT 05401-1473. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anatomic Pathology, Allopathic & Osteopathic Physicians / Pediatric Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology is her primary health care specialty. Waters, Brenda Lorraine can be contacted via phone (802) 847-2797.

Contact Information

Primary practice address
111 Colchester Ave Burlington VT 05401-1473
Phone: (802) 847-2797
Fax: (802) 847-9644
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology 207ZP0101X 042-0006733 Vermont
Allopathic & Osteopathic Physicians / Pediatric Pathology 207ZP0213X 042-0006733 Vermont

Profile Details

NPI number 1366477960
LBN Legal business name Waters, Brenda Lorraine
Credentials M.D., B.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366477960 NPPES
New York MEDICAID 01166976
New York MEDICAID 0009551

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