Individual
KATHLEEN MANNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
97 SHERMAN DR, ST. JOHNSBURY PEDIATRICS, ST JOHNSBURY, VT 05819-9280
(802) 748-5131
(802) 748-4237
Mailing address
97 SHERMAN DRIVE, ST. JOHNSBURY, VT 05819
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1010010350
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1005218
—
VT
05
—
30008265
—
NH
Enumeration date
06/05/2006
Last updated
03/22/2012
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