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General NPI Number Information
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NPI Number | 1679768758
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Entity Type | Individual
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Provider Name | JENIFFER TOBON ARNP
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Gender | Female
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 01/14/2021
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Provider Practice Location Address
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Address Line | 1 NATIONAL LIFE DR
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City | MONTPELIER
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State | VT
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Zip | 05604-9516
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Country | US
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Telephone | 802-229-7515
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Fax | 802-229-7518
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Provider Business Mailing Address
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Address Line | 496 S CRAFTSBURY RD
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City | CRAFTSBURY
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State | VT
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Zip | 05826-9002
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Country | US
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Telephone | 206-303-0094
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 101.0134154
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License Number State | VT
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