Individual
DIANE E MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
185 SHERMAN DR, SUITE 2, ST JOHNSBURY, VT 05819-9811
(802) 748-5041
(802) 748-5094
Mailing address
165 SHERMAN DR, ST JOHNSBURY, VT 05819-9811
(802) 748-9405
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
1010021194
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014206
—
VT
Enumeration date
10/09/2007
Last updated
07/20/2010
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