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Organization
JOHNSON STATE COLLEGE
Active
Organization
JOHNSON STATE COLLEGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN CASS NP (MANAGER)
(802) 635-1265
Entity
Organization
Contact information
Practice address
337 COLLEGE HL, JOHNSON, VT 05656-9741
(802) 635-1265
Mailing address
337 COLLEGE HL, JOHNSON, VT 05656-9741
(802) 635-1265
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00028275
BCBS
VT
05
—
1005879
—
VT
Enumeration date
04/18/2007
Last updated
10/26/2011
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