Healthcare Provider Details

I. General information

NPI: 1518545383
Provider Name (Legal Business Name): JENNIFER SELLAND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

859 OLD COUNTY RD
WAITSFIELD VT
05673-6221
US

IV. Provider business mailing address

PO BOX 1150
BURLINGTON VT
05402-1150
US

V. Phone/Fax

Practice location:
  • Phone: 802-225-3938
  • Fax: 802-371-4491
Mailing address:
  • Phone: 802-847-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number042.0018094
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: