Individual
ELIZABETH A ELLIS-KEMPNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
790 COLLEGE PKWY, COLCHESTER, VT 05446-3007
(802) 847-1170
Mailing address
144 CUMBERLAND ROAD, BURLINGTON, VT 05401
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0260016161
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0016161
FLETCHER ALLEN PREFERRED
VT
05
—
1013265
—
VT
01
—
6003980
MVP
—
01
—
69710
BLUE CROSS BLUE SHIELD
—
Enumeration date
12/11/2006
Last updated
11/11/2014
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