Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 042.0013826 | VT |
N | 207SG0201X | Clinical Genetics (M.D.) | 10308185-1205 | UT |
N | 208000000X | Pediatrician | 042.0013826 | VT |
N | 208000000X | Pediatrician | 290272 | NY |
NPI | 1346668399 |
---|---|
Provider Name | Katherine J Anderson |
First Address | Burlington, VT 05401-1417 |
Second Address | Burlington, VT 05401-1473 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2014 |
Last Update Date | 22/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F813303 | (05) | VT |