Individual
JILLIAN VANDIVEER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAA
Contact information
Practice address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-0000
Mailing address
PO BOX 840862, DALLAS, TX 75284-0862
(303) 377-7638
(303) 780-0787
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
135.0000097
VT
367500000X
Certified Registered Nurse Anesthetist
135.0000098
VT
367H00000X
Anesthesiologist Assistant
ANT.0000249
CO
Other
Enumeration date
04/17/2024
Last updated
12/24/2025
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