Healthcare Provider Details

I. General information

NPI: 1962626663
Provider Name (Legal Business Name): KIM BARBER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 ARTHUR LN
MILTON VT
05468-3896
US

IV. Provider business mailing address

11 ARTHUR LN
MILTON VT
05468-3896
US

V. Phone/Fax

Practice location:
  • Phone: 802-893-2800
  • Fax:
Mailing address:
  • Phone: 802-893-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number026-0023625
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: