Provider Demographics
NPI:1366467177
Name:RAYFIELD, HOLLIDAY KANE (MD)
Entity Type:Individual
Prefix:DR
First Name:HOLLIDAY
Middle Name:KANE
Last Name:RAYFIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 MAIN ST
Mailing Address - Street 2:STE 1
Mailing Address - City:ESSEX JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05452-6100
Mailing Address - Country:US
Mailing Address - Phone:802-288-1087
Mailing Address - Fax:
Practice Address - Street 1:55 MAIN ST
Practice Address - Street 2:STE 1
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452-6100
Practice Address - Country:US
Practice Address - Phone:802-288-1087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT04200097262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN 2335Medicaid
VTEX9812Medicare PIN