Individual
KATHLEEN JACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
156 MAIN ST, MONTPELIER, VT 05602-2702
(802) 223-4738
(802) 223-6067
Mailing address
PO BOX 547, CENTRAL VERMONT MEDICAL CENTER - FINANCE DEPT, BARRE, VT 05641-0547
(802) 223-4738
(802) 223-6067
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
101-0026217
VT
208D00000X
General Practice Physician
1010026217
VT
363LF0000X
Family Nurse Practitioner
Primary
101.0026217
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009335
—
VT
Enumeration date
06/02/2006
Last updated
12/04/2014
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