Individual
JILLIAN LEIGH BRENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
617 RIVERSIDE AVE, BURLINGTON, VT 05401-1601
(802) 264-8158
(802) 860-4313
Mailing address
617 RIVERSIDE AVE, BURLINGTON, VT 05401-1601
(802) 264-8158
(802) 860-4313
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0420012666
VT
208M00000X
Hospitalist Physician
Primary
042.0012666
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022382
—
VT
01
—
P01338829
RAILROAD MEDICARE
VT
Enumeration date
06/03/2010
Last updated
04/16/2015
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