Provider Demographics
NPI:1295162063
Name:LOMBARD, KATHLEEN (FNP)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:LOMBARD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:PARAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:44 COLLINS DR STE 202
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753-8502
Mailing Address - Country:US
Mailing Address - Phone:802-388-1338
Mailing Address - Fax:802-388-8244
Practice Address - Street 1:44 COLLINS DR STE 202
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-8502
Practice Address - Country:US
Practice Address - Phone:802-388-1338
Practice Address - Fax:802-388-8244
Is Sole Proprietor?:No
Enumeration Date:2013-10-10
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0091188363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily