Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 101.0054995 | VT |
NPI | 1003047788 |
---|---|
Provider Name | Melissa Rowe |
First Address | Williston, VT 05495-7586 |
Second Address | Bennington, VT 05201-2870 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2009 |
Last Update Date | 06/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1016707 | (05) | VT |