Cousins, Candis Joan
Cousins, Candis Joan is an individual health care provider with primary practice located at 364 Dorset St Ste 2, South Burlington VT 05403-6270. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Cousins, Candis Joan can be contacted via phone (802) 859-9500.Contact Information
Primary practice address
364 Dorset St Ste 2
South Burlington VT 05403-6270
Phone: (802) 859-9500
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 550030284 | Vermont |
Profile Details
| NPI number | 1831207166 |
|---|---|
| LBN Legal business name | Cousins, Candis Joan |
| Credentials | PAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 28th, 2006 |
| Last updated | Feb 7th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831207166 | NPPES |
| Other | 08V151 | MVP | |
| MEDICAID | 2000061 | MVP |
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