| Doctor Name: | AGNES MIKIJANIEC |
| NPI Number: | 1093741571 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | 026-0029155 |
| Business Practice Address: | 17 Belmont Ave Att'n: Marilyn Boudreau Brattleboro, VT - 053016613 |
| Business Phone Number: | 8022578382 |
| Business Fax Number: | 8022518466 |
| Mailing Address: | 17 Belmont Ave, Att'n: Marilyn Boudreau BRATTLEBORO |
| State: | VT |
| Postal Code: | 053016613 |
| Phone Number: | 8022578382 |
| Fax Number: | 8022518466 |
| NPI Enumeration Date: | 06/25/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | 026-0029155 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |