Individual
MRS. SAMANTHA BURNHAM INGERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4384 MAIN STREET, MANCHESTER, VT 05254-9207
(802) 768-9136
(802) 662-2173
Mailing address
PO BOX 255, MANCHESTER, VT 05254-0255
(802) 768-9136
(802) 662-2173
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
088196-23
NH
363LP0200X
Pediatric Nurse Practitioner
Primary
101.0134299
VT
363LP0200X
Pediatric Nurse Practitioner
F382385-1
NY
Other
Enumeration date
08/18/2014
Last updated
10/23/2023
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