Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 101.0110937 | VT |
N | 363LG0600X | Nurse Practitioner - Gerontology | 101.0110937 | VT |
NPI | 1083001713 |
---|---|
Provider Name | Megan Houston |
First Address | South Burlington, VT 05403-6905 |
Second Address | South Burlington, VT 05403-7204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2015 |
Last Update Date | 21/04/2015 |