Provider Demographics
NPI:1396219580
Name:SHEEHAN, KRISTEN MARIE (APRN)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:MARIE
Last Name:SHEEHAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 N MAIN ST STE C-3
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-3020
Mailing Address - Country:US
Mailing Address - Phone:802-770-1814
Mailing Address - Fax:802-636-6285
Practice Address - Street 1:198 N MAIN ST STE C-3
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-3020
Practice Address - Country:US
Practice Address - Phone:802-770-1814
Practice Address - Fax:802-636-6285
Is Sole Proprietor?:No
Enumeration Date:2019-01-22
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0134262363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily