Individual
CONNIE FISK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1 COMMONS ST, RUTLAND, VT 05701-4652
(802) 747-1857
(802) 747-1026
Mailing address
160 ALLEN ST, RUTLAND, VT 05701-4560
(802) 747-1857
(802) 747-0129
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
F401672
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
101.0134648
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03772176
—
NY
Enumeration date
12/02/2013
Last updated
10/27/2020
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