Provider Demographics
NPI:1376186551
Name:GEE, NINA ELAINE (LAC)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:ELAINE
Last Name:GEE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 N END DR
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-9157
Mailing Address - Country:US
Mailing Address - Phone:609-330-6734
Mailing Address - Fax:
Practice Address - Street 1:90 MAHONEY AVE
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4836
Practice Address - Country:US
Practice Address - Phone:802-773-0010
Practice Address - Fax:802-773-0010
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT091.0118610171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist