Individual
KAITLIN E BRENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4178 HIGHBRIDGE RD, FAIRFAX, VT 05454-5446
(802) 582-2600
Mailing address
44 MAIN ST STE 200, RICHFORD, VT 05476-1141
(802) 255-5500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
055-0030917
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000380
—
VT
Enumeration date
02/07/2008
Last updated
01/15/2024
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