Individual
KELLY BRUSH DAVISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
128 LAKESIDE AVE STE 115, BURLINGTON, VT 05401
(802) 860-1928
(802) 860-0192
Mailing address
128 LAKESIDE AVE STE 115, BURLINGTON, VT 05401-4936
(802) 860-1928
(802) 860-0192
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1010122886
VT
Other
Enumeration date
11/02/2013
Last updated
03/01/2019
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