| NPI | 1750596110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL S ANSELMO Director Of Health Services 802-440-4426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: VT 0260009599) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VT 0260008617) |
| 163W00000X Registered Nurse (Licence: VT 0260029265) | |
| 207Q00000X Family Medicine (Licence: VT 0420010651) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-08-22 |