Healthcare Provider Details

I. General information

NPI: 1477747277
Provider Name (Legal Business Name): RYAN KATHLEEN CAMPBELL ALBERTSON N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2007
Last Update Date: 07/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 PEARL STREET UNIVERSITY OF VERMONT
BURLINGTON VT
05473
US

IV. Provider business mailing address

PO BOX 250
SHELBURNE VT
05482-0250
US

V. Phone/Fax

Practice location:
  • Phone: 802-656-0123
  • Fax: 802-656-0779
Mailing address:
  • Phone: 877-698-8496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number101-0043286
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: