Individual
KIM A. LADUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
130 FISHER RD, MOB-A SUITE 2-1, BERLIN, VT 05602-9516
(802) 225-5660
(802) 229-9533
Mailing address
PO BOX 547, ATT: CVMC FINANCE DEPT, BARRE, VT 05641-0547
(802) 225-5660
(802) 229-9533
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1010013563
VT
363LP2300X
Primary Care Nurse Practitioner
1010013563
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010501
—
VT
Enumeration date
08/16/2006
Last updated
11/24/2014
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