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Contact Information

KATHLEEN JACKMAN, APRN
156 MAIN ST
MONTPELIER, VT05602-2702
 Phone: 802-223-4738
 Fax: 802-223-6067
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for KATHLEEN JACKMAN · (Female)

NPI # 1902844004
Status Active
Credentials APRN (Advanced Practice Registered Nurse)
Entity Individual
Enumeration date 06/02/2006
Last updated 12/04/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • VT License # 101-0026217
  • VT License # 101.0026217
  • VT License # 1010026217
  • VT Medicaid 1009335
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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