Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 101-0031536 | VT |
NPI | 1578625778 |
---|---|
Provider Name | Robin Sherman |
First Address | Burlington, VT 05401-5429 |
Second Address | Burlington, VT 05401-5301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2006 |
Last Update Date | 11/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013928 | (05) | VT |