Provider Demographics
NPI:1376841510
Name:KIRKPATRICK, JANE (RPH)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 ROCKINGHAM ST
Mailing Address - Street 2:
Mailing Address - City:BELLOWS FALLS
Mailing Address - State:VT
Mailing Address - Zip Code:05101-1331
Mailing Address - Country:US
Mailing Address - Phone:802-463-9910
Mailing Address - Fax:
Practice Address - Street 1:112 ROCKINGHAM ST
Practice Address - Street 2:
Practice Address - City:BELLOWS FALLS
Practice Address - State:VT
Practice Address - Zip Code:05101-1331
Practice Address - Country:US
Practice Address - Phone:802-463-9910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-12
Last Update Date:2011-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT33-2883183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist