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Individual

KATHLEEN BURGESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
19 BELMONT AVE STE 103, BRATTLEBORO, VT 05301-6761
(802) 258-3905
Mailing address
600 BLAIR PARK RD STE 285, WILLISTON, VT 05495-7586
(802) 288-1140
(802) 288-1144

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
042.0011317
VT
207Q00000X
Family Medicine Physician
209588
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1301128
MA
Enumeration date
01/23/2006
Last updated
06/30/2023
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