Individual
MRS. HEATHER ANNE LAROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
789 PINE ST, BURLINGTON, VT 05401
(802) 864-0693
(802) 860-6613
Mailing address
600 BLAIR PARK RD, SUITE 190, WILLISTON, VT 05495
(802) 872-4343
(802) 872-0282
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
011444
NY
363AM0700X
Medical Physician Assistant
Primary
0550030631
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002358
—
VT
01
—
00038362
BCBS
VT
Enumeration date
07/26/2005
Last updated
06/07/2013
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