Individual
JANE HELENA MICCICHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
97 SHERMAN DR, SUITE 1, ST JOHNSBURY, VT 05819-9280
(802) 748-5131
(802) 748-4237
Mailing address
103 TIMBER LN, FRANCONIA, NH 03580-5021
(603) 823-8554
(603) 823-8554
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1010015859
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1005217
—
VT
05
—
30008266
—
NH
Enumeration date
08/30/2006
Last updated
07/08/2007
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