Fauntleroy, Jennifer Mary

Fauntleroy, Jennifer Mary is an sole proprietor health care provider with primary practice located at 11 Court Sq , Rutland VT 05701-4030. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Fauntleroy, Jennifer Mary can be contacted via phone (802) 775-1398.

Contact Information

Primary practice address
11 Court Sq Rutland VT 05701-4030
Phone: (802) 775-1398
Fax: (802) 775-5196
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 042-0009568 Vermont

Profile Details

NPI number 1669448981
LBN Legal business name Fauntleroy, Jennifer Mary
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 27th, 2006
Last updated Jul 8th, 2007 - about 19 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 1669448981 NPPES
Vermont MEDICAID OVN1669

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