# SHELBURNE PEDIATRICS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164624300
- **Authorized official:** JEANNE KELLNER MD (OWNER)
- **Authorized official phone:** (802) 985-5099

## Contact information

- **Practice address:** 10 MARSETT RD, SUITE 2, SHELBURNE, VT 05482-6640
- **Practice address phone:** (802) 985-5099
- **Practice address fax:** (802) 985-2336
- **Mailing address:** 10 MARSETT RD, SUITE 2, SHELBURNE, VT 05482-6640
- **Mailing address phone:** (802) 985-5099
- **Mailing address fax:** (802) 985-2336

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | VT | Yes |

## Other

- **Enumeration date:** 06/01/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1012925 | — | VT |