Healthcare Provider Details

I. General information

NPI: 1295994937
Provider Name (Legal Business Name): JESSICA L. HEATH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA LINDA PATTERSON

II. Dates (important events)

Enumeration Date: 06/07/2008
Last Update Date: 07/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLCHESTER AVE UVM MEDICAL CENTER - CHILDREN'S, PEDI-HEM/ONC
BURLINGTON VT
05401-1473
US

IV. Provider business mailing address

111 COLCHESTER AVE UVM MEDICAL CENTER - CHILDREN'S, PEDI-HEM/ONC
BURLINGTON VT
05401-1473
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-2850
  • Fax: 802-847-5557
Mailing address:
  • Phone: 802-847-2850
  • Fax: 802-847-5557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number62377
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number2009-00950
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number042.0013216
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: