Provider Demographics
NPI:1588615991
Name:EUGAIR, KIMBERLY ANN (FAMILY NURSE PRACTIT)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:ANN
Last Name:EUGAIR
Suffix:
Gender:F
Credentials:FAMILY NURSE PRACTIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 ALLEN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-4776
Mailing Address - Country:US
Mailing Address - Phone:802-236-9472
Mailing Address - Fax:802-770-1851
Practice Address - Street 1:98 ALLEN ST STE 2
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4776
Practice Address - Country:US
Practice Address - Phone:802-770-1850
Practice Address - Fax:802-770-1851
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1010021584363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1008860Medicaid
VT043346203012OtherTRICARE
VT1588615991Medicaid
VTVERM31138660OtherBC BS OF VERMONT
VT043346203 0078OtherCIGNA
VT043346203 0078OtherCIGNA
VT043346203012OtherTRICARE