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General NPI Number Information
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NPI Number | 1164774808
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Entity Type | Individual
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Provider Name | SHANNON RIVARD ARNP
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Gender | Female
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Dates
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Enumeration Date | 10/04/2012
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 1311 BARRE MONTPELIER ROAD SUITE 400
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City | BERLIN
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State | VT
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Zip | 05602
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Country | US
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Telephone | 802-225-3970
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Fax |
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Provider Business Mailing 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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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP60310467
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 101.0134328
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License Number State | VT
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