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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 15 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 1831207166 NPPES
Other 08V151 MVP
MEDICAID 2000061 MVP

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