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General NPI Number Information
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NPI Number | 1528191608
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Entity Type | Individual
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Provider Name | LAUREL H KELLIHER FNP
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Gender | Female
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 01/29/2020
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Provider Practice Location Address
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Address Line | 11 BURNHAM AVE
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City | RUTLAND
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State | VT
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Zip | 05701-3205
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Country | US
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Telephone | 866-476-1321
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Fax | 802-660-9437
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Provider Business Mailing Address
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Address Line | 784 HERCULES DR STE 110
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City | COLCHESTER
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State | VT
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Zip | 05446-8049
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Country | US
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Telephone | 802-448-9787
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Fax | 802-660-9438
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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 | 1010021166
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License Number State | VT
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