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General NPI Number Information
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NPI Number | 1396219580
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Entity Type | Individual
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Provider Name | KRISTEN MARIE SHEEHAN APRN
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Gender | Female
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Dates
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Enumeration Date | 01/22/2019
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Last Update Date | 04/18/2024
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Provider Practice Location Address
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Address Line | 198 N MAIN ST STE C-3
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City | RUTLAND
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State | VT
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Zip | 05701-3020
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Country | US
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Telephone | 802-770-1814
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Fax | 802-636-6285
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Provider Business Mailing Address
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Address Line | 198 N MAIN ST STE C-3
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City | RUTLAND
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State | VT
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Zip | 05701-3020
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Country | US
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Telephone | 802-770-1814
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Fax | 802-636-6285
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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 | 101.0134262
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License Number State | VT
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