Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 420005500 | VT |
NPI | 1962421214 |
---|---|
Provider Name | Dr. Ann P. Guillot |
First Address | Burlington, VT 05401-4514 |
Second Address | Burlington, VT 05401-1473 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0004396 | (05) | VT |
00653172 | (05) | NY |
B85436 | (02) |