Individual
DR. NICOLE R HYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
111 COLCHESTER AVE, RHEUMATOLOGY ACC 5TH FLOOR, BURLINGTON, VT 05401-1473
(802) 847-4574
Mailing address
393 TWIN PEAKS RD, WATERBURY CENTER, VT 05677-7059
(802) 244-8405
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
0420011649
VT
390200000X
Student in an Organized Health Care Education/Training Program
0600002821
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1015498
—
VT
Enumeration date
03/16/2007
Last updated
09/03/2009
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