Mckibben, Patricia Logan

Mckibben, Patricia Logan is an individual health care provider with primary practice located at 111 Colchester Ave , Burlington VT 05401-1473. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Mckibben, Patricia Logan can be contacted via phone (802) 847-3640.

Contact Information

Primary practice address
111 Colchester Ave Burlington VT 05401-1473
Phone: (802) 847-3640
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 0740000157 Vermont

Profile Details

NPI number 1023235835
LBN Legal business name Mckibben, Patricia Logan
Credentials RD, CD
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2007
Last updated Jul 8th, 2007 - about 17 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 1023235835 NPPES
Vermont Other 0740000157 STATE LICENSE NUMBER

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