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LYNNE L COLVILLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
275 ROUTE 30 N, BOMOSEEN, VT 05732-9647
(802) 468-5641
(802) 468-2923
Mailing address
275 ROUTE 30 N, BOMOSEEN, VT 05732-9647
(802) 468-5641
(802) 468-2923

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
101-0011925
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0NS2006
VT
Enumeration date
04/24/2007
Last updated
08/30/2012
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