Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 042-0009941 | VT |
NPI | 1033286216 |
---|---|
Provider Name | Beth Diane Kirkpatrick |
First Address | Westford, VT 05494-9738 |
Second Address | Burlington, VT 05401-1473 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02040288 | (05) | NY |
0VN2105 | (05) | VT |
H04401 | (02) |