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General NPI Number Information
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NPI Number | 1114984093
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Entity Type | Individual
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Provider Name | KATHLEEN GORMAN NNP
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Gender | Female
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 111 COLCHESTER AVE
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City | BURLINGTON
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State | VT
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Zip | 05401-1473
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Country | US
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Telephone | 802-847-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 21909 N 120TH AVE
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City | SUN CITY
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State | AZ
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Zip | 85373-5672
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Country | US
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Telephone | 602-549-3443
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Fax | 623-492-0390
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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 | 363LN0005X
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Taxonomy Name | Critical Care Neonatal Nurse Practitioner
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License Number | 096168
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | 101-0134511
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License Number State | VT
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