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Individual

KERRY A GOULETTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
184 S WINOOSKI AVE, BURLINGTON, VT 05401-4535
(802) 864-6309
Mailing address
617 RIVERSIDE AVE, BURLINGTON, VT 05401-1601
(802) 864-6309

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0550030759
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0030759
FLETCHER ALLEN PREFERRED
VT
01
4148045
MVP
01
69121
BLUE CROSS BLUE SHIELD
05
9000250
VT
Enumeration date
05/31/2006
Last updated
08/19/2025
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