Individual
SAMUEL M. KIPPENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
25 RIDGEWOOD RD, ESNE/SPRINGFIELD HOSPITAL EMERGENCY DEPARTMENT, SPRINGFIELD, VT 05156-3050
(802) 885-7540
Mailing address
25 RIDGEWOOD RD, ESNE/SPRINGFIELD HOSPITAL EMERGENCY DEPARTMENT, SPRINGFIELD, VT 05156-3050
(802) 885-7540
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
055.0031092
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30337990
—
NH
05
—
9000464
—
VT
Enumeration date
02/17/2010
Last updated
10/23/2013
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