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NPI Code Detail

MEDICARE: JENNIFER LAROSE

MEDICARE: JENNIFER LAROSE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1669304960
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER LAROSE
Provider Business Mailing Address
First Line : 102 S WINOOSKI AVE
Second Line :
City : BURLINGTON
State : VT
Zip : 05401-7406
Country : US
Telephone Number : 802-488-6920
Fax Number : 802-488-6919
Provider Business Practice Location Address
First Line : 102 S WINOOSKI AVE
Second Line :
City : BURLINGTON
State : VT
Zip : 05401-7406
Country : US
Telephone Number : 802-488-6000
Fax Number : 802-488-6919
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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