Kelly, Jamie L

Kelly, Jamie L is an individual health care provider with primary practice located at 111 Colchester Ave Accmp2, Burlington VT 05401-1473. 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. Kelly, Jamie L can be contacted via phone (802) 847-0000.

Contact Information

Primary practice address
111 Colchester Ave Accmp2 Burlington VT 05401-1473
Phone: (802) 847-0000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 055-0031104 Vermont

Profile Details

NPI number 1407805708
LBN Legal business name Kelly, Jamie L
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 6th, 2006
Last updated Jun 17th, 2011 - about 13 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 1407805708 NPPES
Vermont Other 276456 MEDICARE ID-TYPE UNSPECIFIED

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