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General NPI Number Information
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NPI Number | 1053033621
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Entity Type | Individual
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Provider Name | KATHRYN ELIZABETH SAMUELSON RN
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Gender | Female
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Dates
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Enumeration Date | 09/12/2022
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Last Update Date | 09/12/2022
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Provider Practice Location Address
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Address Line | 1073 E ARLINGTON RD
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City | ARLINGTON
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State | VT
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Zip | 05250-8497
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Country | US
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Telephone | 802-430-4412
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Fax |
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Provider Business Mailing Address
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Address Line | 431 E ARLINGTON RD APT A
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City | ARLINGTON
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State | VT
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Zip | 05250-9124
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Country | US
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Telephone | 802-430-4412
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 026.0095543
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License Number State | VT
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