Healthcare Provider Details

I. General information

NPI: 1982946661
Provider Name (Legal Business Name): JENNIFER MARIE COVINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2013
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 CREST RD
SAINT ALBANS VT
05478-9701
US

IV. Provider business mailing address

11 CREST RD
SAINT ALBANS VT
05478-9701
US

V. Phone/Fax

Practice location:
  • Phone: 802-527-8189
  • Fax:
Mailing address:
  • Phone: 802-527-8189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number042.0013379
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number042-0013379
License Number StateVT
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number308839
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: