Individual
MRS. CHERYL GAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 864-0111
Mailing address
4 MYERS CT, SOUTH BURLINGTON, VT 05403-6409
(802) 864-0111
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0550031022
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000201
—
VT
Enumeration date
06/17/2006
Last updated
02/10/2011
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