Individual
WYNNE M KIRSCHBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
792 COLLEGE PKWY, SUITE302, COLCHESTER, VT 05446-3052
(802) 655-4900
(802) 655-5017
Mailing address
792 COLLEGE PKWY, SUITE302, COLCHESTER, VT 05446-3052
(802) 655-4900
(802) 655-5017
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0550030813
VT
363AS0400X
Surgical Physician Assistant
0550030813
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000350
—
VT
Enumeration date
05/10/2007
Last updated
02/01/2008
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