Organization
GREEN MOUNTAIN HOUSE CALLS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROLYN E GOODWIN FNP (OWNER)
(802) 558-9502
Entity
Organization
Contact information
Practice address
994 DORSET WEST ROAD, DORSET, VT 05255
(802) 558-9502
Mailing address
PO BOX 550, 994 DORSET WEST ROAD, DORSET, VT 05255
(802) 558-9502
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1010026561
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ONP4498
—
VT
Enumeration date
03/31/2015
Last updated
04/13/2015
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