Individual
JENNIFER G. HUMPHRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
149 SOUTH BAYLEY HAZEN RD., HOME ACRES FARM, RYEGATE, VT 05042
(802) 584-4679
Mailing address
PO BOX 202, PLAINFIELD, VT 05667-0202
(802) 454-1915
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
025.0069058
VT
Other
Enumeration date
10/19/2010
Last updated
10/19/2010
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