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MR. PATRICK CORNELIUS KEARNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
28 PARK AVE, WILLISTON, VT 05495-9701
(802) 878-1008
(802) 872-2679
Mailing address
28 PARK AVE, PRIMARY CARE, WILLISTON, VT 05495-9701
(802) 878-1008
(802) 872-2679

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
055-0030829
VT
363A00000X
Physician Assistant
055-0030968
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9000255
VT
01
AP260801
MEDICARE PTAN
Enumeration date
02/02/2006
Last updated
11/25/2014
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