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PENNY FOSSMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, RN

Contact information

Practice address
44 S MAIN ST, RANDOLPH, VT 05060
(802) 728-7000
Mailing address
PO BOX 1716, HAINES, AK 99827-1716
(907) 314-0525

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
026.0137896
VT
163W00000X
Registered Nurse
NUR R 33273
AK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
101.0134278
VT

Other

Enumeration date
01/15/2014
Last updated
04/05/2019
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