Goulette, Kerry A

Goulette, Kerry A is an individual health care provider with primary practice located at 617 Riverside Ave , Burlington VT 05401-1601. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Goulette, Kerry A can be contacted via phone (802) 864-6309.

Contact Information

Primary practice address
617 Riverside Ave Burlington VT 05401-1601
Phone: (802) 864-6309
Fax: (802) 860-4324
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0550030759 Vermont

Profile Details

NPI number 1487691614
LBN Legal business name Goulette, Kerry A
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487691614 NPPES
Other 4148045 MVP
Other 69121 MVP
MEDICAID 9000250 MVP
Other 0030759 MVP
Other 69121 MVP

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