Provider Demographics
NPI:1477747277
Name:ALBERTSON, RYAN KATHLEEN CAMPBELL (NP)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:KATHLEEN CAMPBELL
Last Name:ALBERTSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:SHELBURNE
Mailing Address - State:VT
Mailing Address - Zip Code:05482-0250
Mailing Address - Country:US
Mailing Address - Phone:877-698-8496
Mailing Address - Fax:
Practice Address - Street 1:425 PEARL STREET
Practice Address - Street 2:UNIVERSITY OF VERMONT
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05473
Practice Address - Country:US
Practice Address - Phone:802-656-0123
Practice Address - Fax:802-656-0779
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101-0043286363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health