Kelley, Lisa

Kelley, Lisa is an sole proprietor health care provider with primary practice located at 1775 Williston Rd Suite 220, South Burlington VT 05403-6491. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Kelley, Lisa can be contacted via phone (802) 861-0200.

Contact Information

Primary practice address
1775 Williston Rd Suite 220 South Burlington VT 05403-6491
Phone: (802) 861-0200
Fax: (802) 861-0210
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 101-0014084 Vermont

Profile Details

NPI number 1447237516
LBN Legal business name Kelley, Lisa
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 29th, 2005
Last updated Aug 13th, 2010 - about 16 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 1447237516 NPPES
Vermont Other 361683 MVP
Vermont Other 5207602 MVP
Vermont Other 00059280 MVP
Vermont MEDICAID 1009149 MVP

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