Basic Information
| Provider Information | |||||||||
| NPI: | 1134589575 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HALL | ||||||||
| FirstName: | KATIE | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 547 | ||||||||
| Address2: | ATT: CVMC FINANCE DEPT | ||||||||
| City: | BARRE | ||||||||
| State: | VT | ||||||||
| PostalCode: | 056410547 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8022234738 | ||||||||
| FaxNumber: | 8022234616 | ||||||||
| Practice Location | |||||||||
| Address1: | 156 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MONTPELIER | ||||||||
| State: | VT | ||||||||
| PostalCode: | 056022702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8022234738 | ||||||||
| FaxNumber: | 8022234616 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2016 | ||||||||
| LastUpdateDate: | 03/10/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 101.0118772 | VT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.