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General NPI Number Information
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NPI Number | 1437618022
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Entity Type | Organization
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Legal Business Name | RUTLAND FAMILY CARE, LLC
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Dates
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Enumeration Date | 03/14/2019
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Last Update Date | 03/14/2019
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Provider Practice Location Address
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Address Line | 25 N MAIN ST
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City | RUTLAND
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State | VT
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Zip | 05701-6100
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Country | US
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Telephone | 802-282-3006
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Fax |
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Provider Business Mailing Address
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Address Line | 33 NORTH ST
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City | MIDDLETOWN SPRINGS
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State | VT
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Zip | 05757-4446
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Country | US
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Telephone | 802-235-3680
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | KRISTEN MARIE SHEEHAN
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Credential | APRN
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Telephone | 802-235-3680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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