Healthcare Provider Details

I. General information

NPI: 1225446230
Provider Name (Legal Business Name): KATHERINE GOYETTE FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2014
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 VILLAGE ROAD
EAST CORINTH VT
05040-9783
US

IV. Provider business mailing address

PO BOX 338
BRADFORD VT
05033-0338
US

V. Phone/Fax

Practice location:
  • Phone: 802-439-5321
  • Fax: 866-244-5145
Mailing address:
  • Phone: 802-222-3026
  • Fax: 802-990-2722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2349700
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP211023
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number070735-23
License Number StateNH
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number101.0105631
License Number StateVT
# 5
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number101.0105631
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: