Healthcare Provider Details

I. General information

NPI: 1306059910
Provider Name (Legal Business Name): KATIE LYN NORTON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 11/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLCHESTER AVE BAIRD 196
BURLINGTON VT
05401-1473
US

IV. Provider business mailing address

111 COLCHESTER AVE., BAIRD 1 FLETCHER ALLEN HEALTH CARE
BURLINGTON VT
05401
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-5222
  • Fax: 802-847-4817
Mailing address:
  • Phone: 802-847-5222
  • Fax: 802-847-4817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number0550031024
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: